SECOND COPY 

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LIBRARY OF CONGRESS. 

Chap. Copyright No 

ShelfSC, Ko'] 

— — iL^ 

UNITED STATES OF AMERICA. 



SHALL WE DRINK WINE? 



A PHYSICIAN'S STUDY 

OF 

THE ALCOHOL QUESTION 



BY/ 

Dr. Jno. Madden 

Professor of Physiology in The Wisconsin College of 
Physicians and Surgeons 



The more concentrated the alcoholic liquor ingested, the more intense the inflam- 
mation of tissue. At the same time an equal quantity of the potable alcohols 
will sooner exhibit their characteristic symptoms if largely diluted with water." 

— Dujardin-Beaumetf, and Audig'e. 



" Nothing, from the physician's standpoint, is falser than to think that the evil 
influence of alcohol is lessened through the increased substitution of beer for the 
stronger alcoholic drinks." — Dr. Adolph von Struempell. 



MILWAUKEE 

PRESS OF OWEN & WEIHBRECHT CO. 
1899 



303 



Copyrighted by the Author. 
1899. 










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N&Mfc^Wj 



^^X. 



PREFACE. 



In the preparation of this essay, the writer acknowledges no 
motive but to discover the truth, and to put it in such form that it 
might be comprehended by the ordinary reader. As to the facts herein 
set forth, they are the result of the laborious, painstaking investiga- 
tions of capable, conscientious, dispassionate men, and they rest upon 
the sound basis of experimental evidence. As to what may be the 
degree of perspicuity in which they are set forth, the reader must 
judge. 

As to the importance of the alcohol question, there can be only 
one opinion. How long can we continue to increase the per capita 
consumption of alcohol at the rate of seventy per cent, every twenty 
years before it becomes evident to the slowest of comprehension that 
something must be done to save civilized races from annihilation ? 
The writer believes, too, that it is the province of the physician more 
than the moralist, more than the philanthropist, and certainly as much 
as the statesman, to do what he may for the suppression of alcohol. 
This essay is, therefore, written certainly as much for the physician 
as for the intelligent layman. 

In closing, the writer wishes to acknowledge the encouragement he 
has received from members of the medical profession, and especially 
the courtesy of Dr. A. Smith of Baden, who kindly permitted the use 
of much material from his valuable work. 

JNO. MADDEN. 
32 & 33 Sentinel Building, 
Milwaukee, May 3, 1899. 



CONTENTS. 



Page. 
I. HISTORICAL, ...... 9 

II. THE CONSTITUENTS OF ALCOHOLIC BEVERAGES, . 29 

III. THE FOOD VALUE OF ALCOHOLIC BEVERAGES, . 38 

IV. ALCOHOL AS A STIMULANT, ... 48 

V. THE EFFECTS OF ALCOHOL UPON DIGESTION AND 

ASSIMILATION, ..... 66 

VI. THE GENERAL PATHOLOGY OF ALCOHOLISM, . 74 

VII. ALCOHOLIC HEART DISEASES, ... 83 

VIII. ALCOHOLIC IRRITATION OF OTHER ORGANS, . .89- 

IX. EFFECTS OF ALCOHOL UPON NERVE TISSUE, 91 

X. THE INFLUENCE OF ALCOHOL UPON EMBRYONIC 

TISSUE AND HEREDITY, .... 102 



CONTENTS— CONTINUED. 

Page. 
XI. ALCOHOL AS A FACTOR IN THE PRODUCTION OF 

INSANITY, ..... 117 

XII. THE ATTITUDE OF THE MEDICAL PROFESSION 

TOWARD ALCOHOL, . . . 128 

XIII. WHO BECOME DRUNKARDS AND WHY ? . . 139 

XIV. WHAT IS INEBRIETY ? .... 141 
XV. INTERMITTENT OR PERIODIC INEBRIETY, . . 144 

XVI. CONSTANT OR HABITUAL INEBRIETY, . . 151 

XVII. POPULAR FALLACIES REGARDING ALCOHOLIC BEVER- 
AGES, ...... 158 

XVIII. SHALL THE PHYSICIAN CEASE TO PRESCRIBE ALCOHOL ? 174 

XIX. EFFECTS OF ALCOHOL UPON CIVILIZATION, . 176 

XX. WHAT IS THE BEST MEANS OF COMBATING THE 

ALCOHOL EVIL ? . . . . . 202 



TO 

DR. N. S. DARLING, 

OF LA PORTE, INDIANA, 

whose abstemious, active, useful life is crowned, in age, by 

a vigourous body and mind, this essay is 

affectionately dedicated. 



SHALL WE DRINK WINE? 

A PHYSICIAN'S STUDY OF 
THE ALCOHOL QUESTION. 



Historical. 

The use of beverages containing alcohol is as old as 
civilization itself. In the countries of the East the mention 
of wine occurs in their earliest legends, and these give it a 
sacred character, attributing its origin to the Gods — Dio- 
nysus in Greece and Osiris in Egypt. The Hebrews cred- 
ited its discovery to Noah, "The second father of the 
human race." Frequent mention of it is made in the 
literature of the Old Testament, where wine with corn and 
oil seem to be regarded as the choicest gifts of the soil 
and the highest achievement of ancient husbandry. Indeed, 
to produce wine in those times was an evidence of greater 
social stability than generally prevailed, for those ancient 
peoples generally lived and moved with their flocks and 
herds, remaining in one place only long enough to make 
one crop of corn. Those engaged in viticulture, however, 
could not be nomadic but must remain in one place to 
await the growth of their vineyards and the maturing of 
their wines. Hence they must have had the power to resist 
the encroachments of the universally warring tribes in 
order to have retained their vineyards and wine presses. 
Thus the making of wine was an index of a more powerful 
and stable civilization. Indeed, the cultivation of the olive 



10 SHALL WE DRINK WINE? 

and the vine required a so much higher order of civiliza- 
tion than the raising of herds and corn that the vine and 
olive became, with these ancient peoples, symbols of refine- 
ment and culture. 

There is evidence that the art of winemaking originated 
in Armenia and other nearby localities of the East. From 
thence it spread westward gaining importance with the 
growth of civilization and commerce ; and, while it had no 
place in the oldest Roman husbandry and was not used in 
the oldest Roman ritual, in the time of the Republic it had 
reached an important place in commerce; for it was arti- 
ficially fostered by laws prohibiting the importation of for- 
eign wines into Italy. 

Probably scarcely less ancient than the making of wine 
from the juice of the grape is the making of an alcoholic 
drink by the fermentation of grains, notably of barley. 
Many hundred years before the Christian era the Egyptians 
practiced the art of brewing, afterwards it was done by 
the Greeks and Romans and ancient Gauls, from which 
peoples it has been handed down through intermediate 
generations to the present time. Herodotus writing about 
450 years B. C. tells us that the Egyptians having no 
vines made wine from corn. It is probable, however, that 
the Egyptians were acquainted with the making of wine as 
well as the art of brewing; for the lands of the Egyptians 
were fertile and well adapted to raising the vine. Further- 
more, the grape is mentioned so often by biblical writers, 
and was elsewhere so abundant, that the historian may not 
have been fully acquainted with the productions of that 
fertile country. Pliny also tells us of the Egyptians mak- 
ing wine from corn, and to this he gives the name of 
"Zythum" which is the Greek equivalent for a drink 
made from barley. Hellanicus, mentioning that wine was 
introduced at Plinthium, an Egyptian city, says, "From 



HISTORICAL. 11 

this source the Egyptians are thought to have derived their 
love for and use of liquor which they think so necessary 
for the human bodies that they made a wine from barley." 
The Greeks who received a great part of their civilization 
from the Egyptians, obtained from them also their knowl- 
edge of making alcoholic drinks from artificial fermenta- 
tion of barley, in short, the process of brewing. Indeed 
in the writings of Archilocus, the Parian poet, we find 
that the Greeks of this day were already acquainted with 
the art of brewing. This was about 700 years B. C. 

Again, from Aeschylus, 470 B. C, Sophocles, 420 B. 
C, and Theophrastus, 300 B. C., we also learn that the 
Greeks used a wine made from barley, not only for festive 
and ceremonial occasions, but also in daily life. There- 
fore, there is little doubt that the use of beer as a beverage 
is nearly as ancient as that of wine itself. Xenophon in an 
account 400 years B. C. in which he speaks of the retreat 
of the ten thousand Greeks, tells us that the inhabitants 
of Armenia used a drink made from barley. Dioscorides 
says that the Galatians also prepared a beverage by fer- 
menting barley, like the Egyptians. Dioscorides makes 
mention of two kinds of beer but does not describe them 
sufficiently to enable a distinction to be made. He says 
that both were made from barley and that liquors of a 
similar nature were made in Spain and Britain from wheat. 
During the life of Tacitus, which was in the first century 
of the Christian era, in describing manners and customs 
of the Germans, he says that their usual beverage was beer 
and, though his description has many imperfections, there 
can be no doubt that they understood the method of mak- 
ing barley malt. The Germans not only made beer in 
abundance, but drank it freely. In Spain beer was used 
under the name of celia and ceria, and in Gaul under the 
name of cerevisia (Pliny's natural history, chapter XXII, 



12 SHALL WE DRINK WINE? 

page 82). Speaking further of the use of intoxicating 
drinks, Pliny says, "The natives who inhabit the west of 
Europe have a liquor by which they intoxicate themselves 
made from corn and water. The manner of making this 
liquid is somewhat different in Gaul, Spain and other coun- 
tries, and it is called by different names, but its nature and 
properties are everywhere' the same. The people in Spain 
particularly brew this liquor so well that it will keep good a 
long time. So exquisite is the cunning of mankind in 
gratifying their vicious appetites that they thus invent 
a method to make water itself produce intoxication." 

The Romans are supposed to have introduced the art 
of malting into Britain. It is evident from Virgil that 
barley was known to the Romans for he speaks of it in 
the plural form, "Hordea." Pliny tells of the Hordearii 
Gladiatores, a kind of fencer, whose chief food was barley. 
The ordinary beverage of a soldier under Caesar was 
vinegar and beer. The former was very strong and was 
drunk diluted with water when on the march. Beer being 
so easily produced with an agricultural people with whom 
corn was plenty, and so suitable to the climate, it soon 
became a natural beverage. Before this time ordinary 
drinks of the ancient Britains were water, milk, and mead. 
The latter was a fermented drink made from honey. After 
the Romans were driven out from Britain the Saxons in- 
vaded the island, subdued its people, and from them 
learned the art of brewing. Various other savage peoples 
have made and are making beverages by malting different 
kinds of grain, or by fermenting natural fluids which con- 
tain sugar. Thus the Kaffir races of South Africa have, 
from remote ages made, and are still making, a beer by 
malting the seed of a variety of Millet (Sorghum Vulgare). 

Natives of Nubia, Abyssinia and other parts of Africa 
also make an intoxicating drink by treating the seeds of 



HISTORICAL. 13 

the Poa, a kind of grass. Beverages have also been made 
from the juice of the palm, cactus, the sap of the maple, 
spruce fir, birch, and ash, the juice of the aloe and many 
other fluids. Indeed, there seems to be scarcely any sub- 
stance yielding a juice containing sugar that has not been 
made to produce an alcoholic beverage by some primitive 
people to whom it was easily accessible. 

*One of the most interesting subjects in medicine 
is the narcotic addiction of savage or semi-savage peoples. 
The making of alcoholic beverages preceded the white 
man's invasion of the countries of both hemispheres. The 
Indians of the Americas, the negroes of many parts of 
Africa, especially equatorial Africa, and the Malays of the 
islands of the Pacific, all had native beverages made by 
subjecting the sugar laden juices of certain plants, or a 
watery mixture of certain malted grains, to alcoholic fer- 
mentation. 

In Central America and Peru Atolle and Chicha were 
made by malting maize flour, and in Mexico Pulque was 
made from the agave and also from the cocoa bean. An- 
other drink called Chocolatl was made from the ripe cocoa- 
bean, which was first ground into a fine flour or meal. 
Next this drink was also fermented, we have reason to 
believe, for we read that the jugs of Chocolatl "with the 
froth still on them were never lacking when Montezuma 
made a meal." 

The Chicha of the Peruvians, which may also have 
been used by the Mexicans, was made like beer from 
malted Indian corn. Narcotic herbs were sometimes 
added to it, after which it was called Sora, and the drinking 
of it was forbidden to many classes, especially the nobles 
and warriors. Drunkenness among the peoples of the old 
American Empires was widespread. Some Spanish writers 

*See Prof. Friedrich Ratzel's " Voelkerkunde," or " History of Mankind." 



14 SHALL WE DRINK WINE? 

attribute their early downfall to this cause, Peru especially. 
The Peruvians are said to have made themselves drunk 
with Chicha before entering battle with their enemies, but 
that instead of bringing victory brought demoralization. 
The early missionaries saw the evils wrought by Chicha in 
Peru and Pulque in Mexico and Yucatan and did what 
was possible to restrict their use. Finally the use of 
Pulque at the festivals of the gods was prohibited by law. 
The Peruvians celebrated a festival of the summer solstice 
during which even natives of low birth were permitted to 
get drunk on this maize beer, and "the days during which 
the festival lasted seem not to have been surpassed in wild 
debauchery by what took place in the temples of Ash- 
taroth and Hathor." The corn beer was made by the 
virgins of the sun, and was a noble offering. The first 
offering was made to the rising sun himself, and carried 
into his temple by pipes; "then the Inca drank to his 
ancestors, to the mummies in whom the sun-god had been 
incarnate, and lastly it was put at the disposal of the 
people." 

The forest Indians of Central and South America also 
had their intoxicating drinks even before the discovery 
of America. These they made of Indian corn, cassava 
bread, the fruits of palms, and bananas. Still there were 
a great many tribes, especially in the southern part of 
South America, which drank only water and chewed the 
juicy stalks of plants. In Guiana pieces of cassava are 
put into a vessel and boiling water poured over them. 
When it is cooled, women chew it and stir it until it 
reaches the consistence of a thick porridge. It is then 
put into a long trough made from the stem of a hollow 
tree and water added, when it is allowed to ferment, the 
ptyalin of the saliva contributing to this result. When 
fermentation takes place it is strained through a reed 



HISTORICAL. 15 

sieve and bottled in gourds. The process is like that of 
preparing Kava in Oceania, and the finished drink is 
called Paiwari. It is yellowish brown in color and tastes 
like sour beer. In contains sufficient quantity of alcohol 
to intoxicate, and the Indian who attends a Paiwari feast 
is pretty sure to get drunk. The ordinary drink of the 
villages is unfermented Paiwari. A good deal of cere- 
mony attends the preparation of Paiwari, as is the case 
with Kava in Oceania. Sugar-cane wine and another 
intoxicating fluid from a mixture of sweet potatoes and 
molasses are made by these people. In the latter fer- 
mentation is set up by the addition of chewed grains of 
maize, the latter acting as a yeast. 

The inhabitants of the mountain regions of Colombia 
and Ecuador make a drink from fermentated watery solu- 
tions of raw sugar, which they call Guarapo. To this 
they add the juice of a small aromatic citron, giving the 
mixture a flavor not unlike that of lemonade. It is also 
drunk before fermentation sets in; it is then called 
"regular" to distinguish it from the other, which is called 
"bravo" A similar drink is made by chewing pieces of 
sugar-cane and spitting them into a calabash, and bot- 
tling the juice in a gourd, where it is allowed to ferment. 
The drink thus prepared is strongly alcoholic and intoxi- 
cating in small quantities. 

Though the great tribes of central and northern North 
America had the sap of the sugar maple, birch, and 
sugar pine, and though they made quantities of sugar 
and were fond of it, they do not seem to have stumbled 
upon the process of fermentation. Not because they dis- 
liked alcohol, surely; for the Indian has always suffered 
great demoralization when he permitted his appetite to be 
gratified with the white man's intoxicants. Neither is 
there any evidence that the tribes inhabiting the cold 



16 SHALL WE DRINK WINE ? 

regions of the southern part of South America have any 
alcoholic liquors. 

Nearly all the negro tribes made an intoxicating drink 
of some kind, beer made from millet or Indian corn 
being the most common. They not only made the 
beverages but drank them to excess. Drunkenness among 
them was quite general, according to Wissmann, who 
advised travelers who intended to transact business with 
them to see them in the morning before the great daily 
drunk began. Beer of this kind was made both north 
and south of the equator, while in the equatorial regions 
there was an abundance of palm and banana wine. The 
Hottentots were an exception, and had no native alcoholic 
drink. 

Among the Australians, the inhabitants of New South 
Wales made a drink from honey by a process of fer- 
mentation; but this seems to be the only native alcoholic 
drink among the people of the island. 

The natives of the Samoan and other Pacific islands 
make fermented drinks from starch bearing plants and 
the juice of the palm. The Malays largely use a wine 
made from the palm and also a slightly alcoholic drink 
made from malted rice and the fermented juice of sugar- 
cane. The Chinwans of Formosa brew a beer from rice 
or millet, fermentation being set up by rice meal which 
has been chewed by an old woman. In Borneo and 
Sumatra, however, the staple drinks are cocoa-nut milk 
and watei. 

That alcoholic excesses prevailed among the people 
of the earliest civilizations, history furnishes abundant 
evidence. The history of later times contains much that 
is more definite concerning the demoralization wrought 
by the immoderate consumption of alcohol ; and no people, 



HISTORICAL. 17 

perhaps, suffered so much in this respect as the Germans. 

Of drunkenness among Germans in the early centuries 
much has been written. "In order to still their hunger," 
wrote Tacitus, "the Germans need no fine preparations, 
nor do they care for delicacies. In their drinking, on 
the contrary, they do not show the same moderation. 
Should one undertake to satisfy their love for drink and 
furnish as much as they desire, he would find it easier 
to conquer them through their vice than by the sword/' 
Also Venantius Fortunatus, Bishop of Borders, thus 
describes a company of drinking gentlemen which he 
met on a journey to the Rhine and Moselle Country; 
"Singers sang and accompanied their songs with music 
on the harp, while around sat the listeners furiously drink- 
ing from large pitchers of maple wood. They drank each 
others health or for a wager; and any one who refused 
to take part in their debauches was considered an ass. 
One should consider himself lucky," continues the bishop, 
"to be alive after such a drinking bout/' (Kurze Ge- 
schichte der Trinksitten; Dr. William Bode.) These 
drank wine and this condition of excessive drinking had 
then a long time persisted. We read that the German 
Emperor, before his coronation in Rome, was asked "Wilt 
thou, with God's help, keep thyself sober?" And only after 
the question received an affirmative answer did he receive 
the crown. 

"Clergymen on the one side, and the gentry, judges, 
and soldiers on the other were often given to drunkenness," 
says Dr. Bode. The common people drank when they 
could obtain the means to purchase the intoxicating 
drinks ; but the leisure classes above mentioned were about 
the only ones who could afford, at this time, the luxury 
of continuous drunkenness. 

And wine and beer were held in high estimation. It 



18 SHALL WE DRINK WINE? 

is related that Rudolph of Hapsburg, after receiving a 
drink of beer, much to his liking, from a burgher of 
Erfurt, rushed into the street waving the empty mug and 
shouting "Well in! well in! A good beer is that made 
by Herr Sifried of Bustade!" ("Wol in! Wol in! Em gut 
bier das hat Herr Sifried uf gethan.") To be able to stand 
a good drunk was regarded as proof of a noble descent. 
Among the Hohenlohe vassals there was an old German 
custom requiring any one put to the test to drain the 
great feudal cup (Lehenbecher), which held a quart of 
beer, at a single draught, as proof of his fitness to serve 
the King. A similar custom ruled among the Alvensleben 
and other feudal peoples. 

Things were scarcely better in the Monasteries, where 
the monks busied themselves with wine and beer making, 
in which they became famous. Frequent and excessive 
drinking was the result. In the French Cloisters matters 
were just as bad. In the famous correspondence between 
Abelard and Heloise, the latter complains of the evils of 
intemperate wine drinking. It pained her to see so much 
drunkenness and coarseness at the table. She quoted 
much from the scriptures and from the holy fathers of 
the church against wine drinking. Especially did she 
quote St. Benedict who says that wine is not a fit drink 
for monks. Still she could not think it right to have it 
completely forbidden to the nuns; because humanity had 
become so weakened and degenerated that they can no 
longer reach their ideals without some artificial aid. "It 
appears," she declared, "as though the world had grown 
old and that humanity had lost its original freshness of 
youth, as though according to the Word, Truth and Love 
had grown cold, not in many, but in all breasts. Since 
mankind has changed, the customs regulating human con- 
duct should be changed or their rudeness moderated." 



HISTORICAL. 19 

Abelard agreed with his friend. He thought that the nuns 
should either abstain entirely or have their wine mixed 
with water, one part of water with three of wine. Neither 
would he forbid drinking to satiety or an amount sufficient 
to satisfy without producing drunkenness; for "it is not 
satiety which is a sin but intemperance." 

We also learn that in the Celebrated Cloister of St. Gaul 
in the tenth century, every monk daily received five quarts 
of beer besides wine in considerable quantity. In North 
Germany, also, intemperance was a greater evil than in 
the south. 

Not, however, until the end of the middle ages did 
the drinking of alcoholic liquors become a national danger 
in Germany. As important cities arose and developed in 
North Germany, beer making became a recognized art and 
breweries sprang up in Einbeck, Braunschweig, Goslar, 
Hamburg, Merseburg, Luebeck, Danzig, Erfurt, Torgau 
and other places. There arose, indeed, as Dr. Bode says, a 
genuine "Beer Cultus" which reached its highest point 
in the sixteenth century. A learned Dr. Placotomas wrote, 
in 1575, in Erfurt "Five books in that Godly and noble 
gift, that sacred and wonderful art of brewing beer 
philosophically." A few years later there appeared in 
Vienna a "Wine book" by John Rosch in which the "wine 
cultus" was held in nearly the same estimation. To drink 
wine was here held to be a service of God (Gottesdienst). 
Drinking, revelry, debauchery, and all manner of coarse- 
ness reached its highest tide during the period just preced- 
ing the thirty years' war, at which time the German people 
were enjoying an era of commercial activity and material 
progress. One has only to read the satirical lampoons 
of that time to learn the extent of drunkenness among 
the leisure classes. Noblemen assailed each other with 
the vile language of the ox drivers (Ochsenknecht). 



20 SHALL WE DRINK WINE ? 

When Duke Henry of Braunschweig" in 1539 called John 
Frederick of Saxony and other noblemen drunken rascals 
these replied that undoubtedly they were sinners in that 
direction, but that Duke Henry himself was even a greater 
offender for he could be found drunk early in the morn- 
ing. "I will not excuse the life at court," wrote Luther 
in 154T. "Unfortunately all Germany is plagued with 
drunkenness. It is a bad old custom in the German land, 
which has grown and still continues to increase." The 
gluttony and drunkenness of that time are vividly 
described in the works of the Silesian poet, Hans von 
Schweinichen (1586), who went on a begging and drink- 
ing journey with Duke Henry XI of Liegnitz, through 
Germany. "These two Silesians were probably the great- 
est drunkards in that drunken century; but they had an 
abundance of company." 

The sixteenth century has been called "the classical 
Age of German Inebriety." This, as has already been 
stated, w r as due largely to the prosperity of the ruling or 
leisure classes; but about the beginning 1 of this century we 
hear, for the first time, complaints of the evils done by 
the stronger alcoholic drinks. In 1496 we read that the 
Nttrenberg council was compelled to take action against 
disorders caused by the immoderate use of brandy, by 
forbidding its purchase on Sundays and holidays, and on 
working days only a half-penny's worth could be sold to 
one purchaser. In other places there must have been 
much drinking of brandy; for we find, for instance, that 
there were 34 distilleries in Zwickau in the early part of 
the sixteenth century. At the same time Frankfurt on 
the Oder had 80 and Zittau had 40. In Berlin brandy 
was allowed to be sold only in the apothecary shops until 

1574. 

Beer, however, continued to be the great national drink 



HISTORICAL. 21 

and it seems to have reached a degree of favor with the 
common people amounting to almost veneration. Not 
only was it used as a beverage by all who could afford 
it, but it was also regarded as a remedy for various 
diseases. Many kinds were manufactured, not only from 
barley alone, but with the addition of other materials, and 
each kind had its peculiar use as a remedy assigned to it. 
We read, for instance, that rosemary beer was good for 
melancholia, "Scordien" beer was good for weak eyes, 
lavender beer "strengthened the head," sage beer "took 
away the trembling of the knee pan" and strengthened 
loosened teeth, and beer made from mugwort was good 
for unfruitful women. Beer was also extraordinarily 
cheap. For a few pfennigs, one could get all that he 
could drink. Three and four pfennigs a quart was the 
price of the best that could be purchased. 

Not only were the German noblemen of this time 
drunkards, but their wives and daughters drank to excess 
as well. It is related that Henry IV of France, though 
certainly not temperate himself, refused to marry a German 
princess because he did not wish to have a wine cask 
constantly by his side. Among all the drunkards of that 
drunken century, Anna of Saxony, daughter of Count 
Moritz, was the most notorious. She had the doubtful 
reputation of being able "to drink all the guests under 
the table/' and finally died of alcoholic insanity. It is 
related that her marriage with William of Orange in 1561 
was celebrated by the drinking of 3600 casks of wine and 
1600 barrels of beer. When Guenther XLI of Schwarz- 
burg married Duchess Catherine of Arnstadt the wedding 
was celebrated by drinking the following wines and beers : 
20 barrels of Malmsey, 25 barrels of Reinfall (a Welsh 
wine), 25 wagon-loads of Rhine wine, 30 barrels of Frank- 
fort and Wuerzburg wine, 6 barrels of Necker wine, 228 



22 SHALL WE DRINK WINE? 

barrels of beer. This was for the use of the guests alone; 
but besides this the servants and peasants received ioio 
pails of "land wine" and 120 barrels of beer with which 
to drink the health of the happy couple. 

Intemperance ruled all classes and both sexes, says Dr. 
Bode. The nobility set the worst possible examples. 
Only a very few of them lived thoughtful sober lives. Of 
the Saxon and Pommeranian nobles scarcely one was not 
a drunkard. Horrible things are related of them by 
Janssen. Count John Frederick of Saxony spent his time 
in arranging drinking bouts for wagers which often ended 
in the severe illness or death of several of the bibulous 
nobles. Count Christian I died of alcoholism. Christian 
II was also a notorious drunkard. When he visited the 
Imperial Court in Prague, in 1607, he prided himself that 
he was not sober a single hour during his visit. A 
foreigner once declared that his face was the face of a 
wild beast rather than that of a nobleman. Six or eight 
hours would sometimes be spent at the table. Now and 
then the drunken nobleman would make some filthy re- 
mark, throw the beer from a partly filled glass into the 
face of a servant or box his ears, or engage in some other 
form of drunken coarseness. As the court ladies con- 
stantly sat at the tables during these scenes it is easy to 
understand that they too drank and got drunk. The 
Duchess of Braunschweig was said to make a remarkable 
spectacle of maudlin happiness whenever she sat at the 
state dinner. 

Citizens, laborers, and farmers emulated the conduct 
of the gentry whenever possible. The council of Nuern- 
berg in 1540 provided for a hand wagon to go about the 
streets and pick up those who had become too drunk to 
walk; and in 1557 they deplored the fact that so many 
serious wounds resulted from drunkenness in artizans of 
both sexes. 



HISTORICAL. 23 

In England and other countries at this time drunken- 
ness was as prevalent as it was in Germany, and affected 
the same classes of people. The gentry of that time, from 
the fox hunting country squire to the prime minister, all 
drank to excess and the lower classes did the same when 
the opportunity presented. To write of drunkenness in 
England would, therefore, be to repeat the chapter on 
drunkenness in Germany for the same time. We have 
only to read the works of contemporary writers to obtain 
a correct view of the drink habits of the English people 
of that time. 

Much has been said about the comparative harmless- 
ness of wine and beer drinking, and that spirits drinking 
is responsible for practically all of the evils of temperance. 
This matter is fully discussed in another place. We can 
see, however, from history that unlimited drunkenness may 
result from indulgence in wine and beer. 

There can be no doubt, however, that the introduction 
of whiskey as a beverage added much to the general de- 
moralization produced by drunkenness. 

Whiskey probably originated among the Celtic in- 
habitants of Ireland and Scotland. Its name is a cor- 
rupted abbreviation of the Celtic Uisage-beatha (Usque- 
baugh), meaning "water of life." Popularly, distilled spirit 
was known as Aqua vitae and was used solely as a power- 
ful medicinal agent. It did not come in general use 
as a beverage until about the middle of the 17th 
century ; and the first law of which we have any knowledge 
for the regulation of its sale was that passed by the town 
council of Glasgow in August, 1655. This act prescribed 
certain rules for the sale of "Ail and Aqua vitae." An 
excise duty was first levied on the "Aqua vitae" consumed 
in England in 1660, and in 1684 duty was paid on 527,492 
gallons. 



24 SHALL WE DRINK WINE? 

From this time on the consumption of ardent liquors 
grew with remarkable rapidity. At the end of the century 
the amount annually consumed reached more than a mil- 
lion gallons and forty-three years later it reached the 
incredible quantity of 8,200,000 gallons. With this rapid 
increase in the imbibition of strong alcoholic liquor, came 
great public demoralization. The liquor could be pro- 
duced cheaply and its sale was practically unrestricted. 
This condition led to the multiplication of gin shops in 
London during the early part of the 18th century and 
so keen was competition that it is said keepers of these 
places put placards in their windows announcing that any- 
one might get drunk for a penny and that "Clean straw 
in comfortable cellars" would be provided for customers 
where they might sleep off the effects of the alcoholic 
narcotism. About this time the London authorities awoke 
to the necessity of passing laws to curb the destructive 
tide of debauchery, but the measures adopted (Gin Act 
1736) were only slightly effectual. Acts were also adopted 
regulating the traffic in Ireland and Scotland about the 
same time; but here as in England they met with only a 
small success. Evasions of the penalties imposed by law, 
by smuggling, dishonest distilling, and the like, were 
incidents in the whiskey traffic then as they are now. 

Comparing the drunkenness of the early centuries with 
that of recent times, it will be seen that there is less of 
brutal excess among the people in the higher and more 
responsible stations of life now than there was in the pre- 
ceding three or four centuries. Not, perhaps, due to the 
fact that there is less alcohol consumed by these classes 
of society so much as to the influence on civilization which 
has softened the manners of all classes and given to all 
a much greater measure of self-restraint. What the per 
capita consumption of any of the European countries was, 



HISTORICAL. 25 

until very recent times, we have no means of knowing. 
It is probable, however, that in none of them was it as 
great as it is at the present time. The great mass of 
people were too poor to indulge, excepting on festive 
occasions, while at the present time some form of alcoholic 
drink is part of the daily diet of nearly all the laboring 
classes of Europe and America. 

With primitive peoples the intoxicating effects of alco- 
holic drink must have been a deep mystery because of an 
inability to connect cause with effect. Unknown forces 
were ascribed to a spirit origin, to the gods, good or 
evil, according to their beneficent or harmful effects on 
man. With the Greeks wine found its apotheosis in 
Bacchus (Dionysus) the son of Jupiter. "He represents 
not only the intoxicating power of wine, but its social and 
beneficient influence likewise; so that he is viewed as a 
promoter of civilization, and a law-giver and lover of 
peace" (Bulfinch's Mythology p. 113). But the evil 
wrought by wine was recognized, even at this early day, 
no less than the apparent good; for did not the Princes of 
Greece undertake to prevent the introduction of Bacchus 
worship into their country "because of the disorders and 
madness it brought with it?" And did not Pentheus, King 
of Thebes, forbid Bacchanalian rites being performed 
within his kingdom, even going so far as to order the 
death of Bacchus? 

This bit of mythology curiously reflects a division of 
public opinion as to the value of wine and its evils which 
persist, if we substitute all alcoholic drinks for wine, to the 
present day. This Grecian Apotheosis of wine is a part 
of our present heritage. Through all of the intervening 
centuries the industries concerned in the production of 
alcoholic beverages have grown and flourished with the 



26 SHALL WE DRINK WINE ? 

growth of civilization. The drinking of wine has been 
regarded by all peoples as a proper mode of expressing 
the greatest human happiness. Is a child safely born to 
us, is a beloved daughter happily married, has a wanderer 
returned, is an enemy defeated, or has the Goddess of 
Fortune smiled upon us? Then let us be happy and give 
appropriate expression to that happiness by sitting down 
with our friends and drinking wine. Not by primitive 
peoples alone has it been deified. Great men of all times 
and nations have dedicated to it some of the best products 
of their minds. It has a high place in song and story. The 
literature of all peoples give it a place in a social organism 
made up of all such elements as make life complete and 
desirable. It figures in the profound solemnities of church 
rituals. It has been regarded as a food for the tender 
years of infancy, a staff for the tottering steps of age, an 
elixir vitae for those impoverished by disease, and a 
blessed nepenthe to soothe away the hours of grief or 
mental irritation. And ale has a literature all its own. 
For more than a thousand years the people of great 
nations have believed that ale gives health, manliness and 
strength; and the great masses of the common people, 
the nation's sinews in peace and war, have made it the 
one indespensible article of their dietaries. The god of 
beer, too, found a materialization in the person of 
Gambrinus, Jean Primus, or John The First of Brabant, 
the stout Flemish duke who is said to have invented 
lager beer. 

Ardent spirits being of more recent date are not sur- 
rounded by the mysteries which surround wine and ale 
and have no god in any mythology; but many generations 
of physicians and influential laymen have given to the 
strong alcoholic drink an undeserved reputation for doing 
good. For many generations has it been used to stimulate 



HISTORICAL. 27 

a flagging heart, promote sleep, relieve pain, increase the 
vital capacity and protect the body from the cold of winter 
and heat of summer. Indeed, the giving of ardent spirits 
has, until very recent years, formed part of the routine 
treatment of nearly all classes of diseases. 

Let anyone consider these things and he will under- 
stand why alcoholic beverages claim vested rights. They 
are a part of our civilization. Like a degenerate member 
of an imperial house ruling an unwilling people their 
evils are patent but they have hereditary rights. They 
have that authority which arises from an uninterrupted 
reign of many generations, they have social, political and 
religious prestige; and more than all, they have the 
prestige which arises from the ready command of un- 
countable millions of material wealth. Furthermore, the 
opinion prevails with nearly all intelligent people that used 
in moderation they are not only not harmful but beneficial 
in their action, and are only to be deprecated when used 
in excess. 

Of drunkenness in modern times we know, un- 
fortunately, too much. In our own country the per capita 
consumption of alcohol is increasing in an alarming de- 
gree. Statistics from the great nations of Europe show a 
like or still greater increase. Statistics for 1896 show 
that ninety million gallons of absolute alcohol was con- 
sumed in the beverages drunk by the inhabitants of the 
United States during that year. Furthermore, the average 
per capita consumption of alcohol during the decade pre- 
ceding 1896 was seventy per cent, greater than that for 
the decade 1875-86. 

This increase in alcohol consumption has been 
attended, pari passu, by an increase in crimes, deeds of 
violence, murder, suicide, manslaughter, and assault, while 
the number of insane to each hundred thousand in- 



28 SHALL WE DRINK WINE ? 

habitants shows a like increase; for ninety million gal- 
lons of alcohol can destroy an enormous amount of 
healthy brain tissue. Something more effective than is 
now in force must be inaugurated to stem the tide of gen- 
eral demoralization or we shall be overwhelmed. Surely, 
however, the magnificent intelligence and practical com- 
mon sense of the American people make them equal to 
dealing with this problem once their attention is sufficiently 
aroused to the dangers threatened by alcohol. 



IL 
Che Constituents of Hlcobolic Beverages* 

The alcoholic beverages commonly drunk are wine, 
spirits (whiskey, brandy, rum and gin), and beer. Wine 
is produced by subjecting grape juice to alcohol fermenta- 
tion, during which process the sugar in the grape juice is 
changed into alcohol and carbonic acid. The amount of al- 
cohol in any wine will depend, therefore, upon the amount 
of sugar in the grape from which it is made. Wines made 
from grapes rich in sugar contain more alcohol than those 
made from grapes which contain a less amount of sugar. 
There is a limit, however, to the amount of alcohol that 
may be produced by this species of fermentation; for the 
process will not go on after the alcohol reaches 15-20 per 
cent, of the fluid. After wines are put in wooden casks, 
however, they become richer in alcohol, for a part of their 
watery contents pass through the wood and evaporate. 
They are also artificially "fortified" by the addition of 
alcohol. Some wines are not allowed to ferment to their 
fullest extent; they, therefore, contain a proportionately 
small amount of alcohol and large amount of sugar. 

The following table from Dr. Weiss (Der Alkohol, 
Seine Wirkung und Sein Wesen) shows the average per- 
centage of alcohol in the different European wines: 

Rhine Wine 6-16 

Mosel Wine 8-13 to 15-25 

Red Bordeaux 6-13 

White Bordeaux 11-19 



30 SHALL WE DRINK WINE ? 

Hungary Wine 9-15 

Italian Wine 14-19 

Red Burgundy 7-14 

White Burgundy 9-12 

Greek Wine 13-18 

Port Wine 16-23 

Sherry 16-25 

Madeira 16-22 

Cape Wine 18-23 

The amount of sugar in different wines varies very 
much. In some all the sugar has been changed into alco- 
hol and carbon dioxid while in others, like sweet catawba, 
the amount of sugar may rise as high as thirty per cent. 

The principal acid of wine is tartaric acid, a constant 
constituent of the grape. Next in importance is tannic 
acid from the grape skins, especially in red wine. Acetic 
acid, an oxidation product from alcohol and succinic acid. 
Carbon dioxid results in considerable quantity from fer- 
mentation in some varieties of grape; but sometimes it is 
added as an artificial substance. Wine also contains oe- 
nanthic acid, which is a substance peculiar to wine and 
arises during the process of sugar fermentation. Wine also 
contains oenanthic ether which imparts to it its peculiar 
odor; but the "bouquet" is not due to this substance, ac- 
cording to Weiss, but to a number of ether like substances 
which are developed at the same time by peculiar kinds of 
sugar fermentation. 

The inorganic substances in wine are potassium, sodi- 
um, calcium, sulphates and phosphates with traces of iron 
and chlorine, the proportion of each being dependent upon 
the character of the soil in which the grape was grown. 
Thus in Mosel, wine which is made from grapes grown on 
a soil of slate clay, may be found acetate of magnesia, alu- 
minium chlorate, and other substances peculiar to that par- 
ticular district. The total amount of inorganic matter var- 
ies from .1% to .3%. 



THE CONSTITUENTS OF ALCOHOLIC BEVERAGES. 31 

The proportion of alcohol, sugar, acid and water 
varies very much with different wines. Sometimes any one 
or more of these substances are added to those already in 
the wine to make it contain the properties usually found in 
a particular kind of wine. 

Wine is much adulterated, the principal material used 
for this purpose being alcohol. Sometimes the alcohol 
used for this is impure, containing not only ethyl alcohol 
but also the heavier and much more poisonous alcohols, 
propyl, butyl and amyl. Unadulterated wine contains only 
the least poisonous ethyl alcohol. Various substances are 
added, also, for the purpose of coloring. Most of these 
are harmless; but fuchsin, often used for the purpose of 
coloring red wine, contains arsenic and may do much 
damage. The extent of this sophistication in Europe may 
be judged from the fact that the island of Medeira pro- 
duces only about 30,000 barrels of wine annually, yet 
50,000 barrels of Madeira wine are yearly exported to the 
United States alone. Our domestic wines are probably 
not adulterated to the extent that the foreign wines are. 
The abundance of grapes have made wines so cheap that 
adulterations would not be profitable. 

Aside from wine from grape juice a great deal of alco- 
holic drink is produced from other fruits of various kinds. 
Apple, pear and orange cider, and wines from currants, 
gooseberries and other small fruits. In pear and apple cider 
the tartaric acid of the grape is represented by malic acid. 
In other respects ciders and fruit wines do not differ from 
those made from grapes. 

All distilled spirits were formerly produced from wine. 
The brandy of commerce is still produced in that way and 
much is manufactured in the countries of Southern Eu- 
rope, France, Spain and Portugal, and in the great wine 
districts of America, especially in California. It contains 



32 SHALL WE DRINK WINE ? 

from 50% to 60% of alcohol, and the volatile substances, 
oenanetic ether and the like, found in wine. An artificial 
brandy is made from a 70% alcohol to which has been 
added oenanthic ether resulting from the oxidation of palm 
oil by distillation with potassium chromate and concen- 
trated sulphuric acid. Brandy is also artificially made by 
the simple addition of oenanthic ether to alcohol diluted, or 
by distilling wine lees after adding acetic and nitrious ether. 
Rum is made from sugar cane and molasses, alcohol 
arising from fermentation as in the case of wine, and formic 
acid resulting as a by-product. After fermentation the 
fluid is subjected to a process of distillation, the formic 
acid passing over with the alcohol. Rum contains from 
60% to 70% of alcohol. It is artificially made by adding 
essence of rum, containing butyric ether, acetic, nitric, and 
formic acid, to dilute alcohol. Arac is made from rice by 
fermentation and distillation. Besides alcohol its chief in- 
gredients are formic and butyric acid. Corn, rye, pota- 
toes and other starch producing materials are used in the 
manufacture of whiskey. Each substance gives rise to a 
whiskey having its own peculiar character which depends 
upon the ether and volatile oils which develop during the 
process of fermentation. Whiskey contains from 30% to 
60% of ethyl alcohol and a small quantity of the heavier 
alcohols. After remaining a long time in barrels these lat- 
ter are said to have been removed by oxidation. This, 
however, has not yet been demonstrated, and is probably 
not true. Potato whiskey, much of which is manufactured 
and drunk in Germany, Ireland and other countries of Eu- 
rope, is said to contain a relatively larger amount of fusel 
oil than that made from any other substance. Amyl alco- 
hol, one of the fusel oil group, is much more poisonous 
bulk for bulk than ethyl alcohol, the relation which they 
bear to each other, being according to Dujardin-Beau- 
metz and Audige, 8 to 1.7. 



THE CONSTITUENTS OF ALCOHOLIC BEVERAGES. 33 

The lethal dose of the various alcohols per kilogram of 
animal weight according to these investigations is as fol- 
lows: Ethyl alcohol 8 grams, propyl alcohol 3.8 grams, 
butyl alcohol 2 grams and amyl alcohol 1.4 to 1.7 grams. 
It should not be forgotten, however, that the effects of the 
heavier alcohols differ in no way from those resulting from 
the ingestion of ethyl alcohol; the difference is one of de- 
gree not of kind. According to Strassman, also, (Experi- 
mentelle Untersuchungen zur Lehre von Chronische Al- 
koholismus) the amount of fusel oil is not more than from 
•3% to -5% of the amount of ethyl alcohol; in other words, 
an amount of fusel oil sufficient to make a 40% whiskey 
equal to one of 41 or 42%. Mobius and Weiss, however, 
regard amyl alcohol as being much more poisonous than 
indicated by Strassman, the latter declaring that a half 
grain is sufficient to produce narcosis and muscular weak- 
ness in an adult. Besides amyl alcohol there results from 
the oxidation of fusel oil valerianic acid and valerianic 
aldehyde. 

Many other kinds of distilled liquors are made, some 
of which contain the volatile oils of different plants. All 
are no doubt more or less injurious; one, absinthe, es- 
pecially so. This is made by distilling wormwood (Artemi- 
sia absinithium) with alcohol. In contains 60-80% of alco- 
hol with the essential oil of the wormwood and is espe- 
cially poisonous to the nervous system, being productive 
of attacks which cannot be differentiated from epilepsy. 
France is the home of absinthe, but the dissipated dwellers 
of all large cities of America and Europe have among them 
3 considerable number of absinthe drinkers. 

Adulterations of spirituous liquors are not infrequent. 
Most of these, however, are in the form of coloring matter, 
sandal wood, turmeric and caramel, which are harmless; 
not, however, so harmless are coloring matters from ani- 



34 SHALL WE DRINK WINE? 

line and naphthalene which are also used for this purpose ; 
and we have also heard of picric acid being used to color 
whiskey which was drunk by men subject to military duty 
to give them a jaundiced appearance so that they might be 
rejected by the military examiner. This substance as well 
as copper sulphate which is sometimes used to produce the 
green color of absinthe are both dangerous poisons. 

By far the most widely consumed and most highly 
estimated alcoholic drink is beer. It is supposed to be 
made of germinating barley; but wheat, oats, rice and In- 
dian corn are largely used in its production. The process 
of germinating produces a substance called diastase which 
has the power of changing starch into sugar, the latter be- 
ing further changed into alcohol and carbon dioxid by 
fermentation as in the case of wine. Hops are added to 
the fluid before fermentation begins. From the malted 
grain is obtained dextrin, sugar, various salts and albumi- 
noid bodies. The hops contain resin, tannic acid, a bitter 
substance called lupulin and volatile oil. Resin and tannic 
acid derived from the hops precipitate, in part at least, the 
albuminoid substances from the grains while the lupulin 
and hop oil remain in solution. 

Beer, then, which is made from malt and hops alone, 
contains water, extractive matter, starch, gums, sugar, dex- 
trine and albumens, alcohol, carbon dioxid, with a small 
amount of succinnic, lactic and acetic acids; salts, chiefly 
the alkaline phosphates and sulphates, pottassium carbon- 
ate, chloride of sodium and silicic acid. Aside from these 
at times beer contains a small quantity of yeast and fat. 

More substances are used in the adulterations of beer 
than of any other alcoholic beverage, some of which are 
harmless and some the opposite. Unmalted grain, the 
husks of which have been soaked in lye, is sometimes 
added to save the expense of malt. From this beer 



THE CONSTITUENTS OF ALCOHOLIC BEVERAGES. 35 

acquires a peculiar bitter taste. Potatoes are mixed with 
the malt giving rise to fusel oil. Potato starch, dextrin, 
couch grass roots, carrots, beets and licorice are all said to 
be used to increase the profits of the brewer. Glycerine is 
also added as a preservative; but it destroys, according to 
Weiss, "double the quantity of malt extract." A small 
quantity of glycerine is a natural constituent of beer, but 
only .02 to .09%. It arises from the splitting up of sugar 
into glycerine and succinic acid. Glycerine, as is well 
known, in considerable quantity and taken for some time 
leads to serious disturbance of the digestive organs and 
the kidneys. 

Substitutions for hops are of much greater variety, and 
as a rule more injurious than substitutions for malt. Any 
thing which will yield tannic acid in abundance may be 
used, the tannic acid taking the place of the ethereal oil and 
resin of the hop. For this purpose hemp is commonly 
used. This substance is well known to medical men as a 
peculiar intoxicant, giving to the subject pleasant hal- 
lucinations at first, and later producing narcosis. It is 
known as "hasheesh" among some eastern peoples. The 
use of hemp as a beer adulterant is not only attested by 
writers on the subject; but I have had this information 
verified by a brewer. The bitter principal of the hop is 
also frequently represented by such substances as orange 
peelings, wormwood, coriander, cardamon, mace, Salvacea 
clara, Ribes nigra, Ruta graveolens; but these are prob- 
ably never, with the exception of wormwood, used in quan- 
tity sufficient to produce harm. Not so harmless, how- 
ever, are other bitters used for the same purpose, such as 
gentian, catechu and quassia which with long use bring 
about serious disturbances of the digestive functions. Still 
more injurious are some of the materials which are said to 
be used for the purpose of adulterating certain foreign ales. 



36 SHALL WE DRINK WINE? 

They are Solarium dulcamara (bitter sweet), one of the 
night shades, its leaves and berries, taxas baccatus, bark, 
leaves and berries, Datura stramonium (a night shade) the 
entire plant, white hellebore, the leaves and root,Colchicum 
autumnale, all parts of which are highly poisonous, and 
even opium. The above is certainly a formidable list of 
violent narcotic poisons which should be used only under 
the careful supervision of a physician. Strychnine produc- 
ing plants, Strychnos mix vomica, Strychnos Ignatii, and 
Strychnos colubrina, are also used to impart the bitter taste 
to beer in the absence of a sufficient quantity of hops. All 
the members of the Strychnos family are very poisonous 
and extremely bitter. To the above really formidable 
poisons may be added, as occasional adulterations of beer 
and ale, colocynth, aloes, and picrotoxin, all dangerous 
poisons. / 

For coloring purposes the materials used are generally 
harmless. They are caramel, scorched malt, and extract 
of chicory. For the purpose of clarifying, however, sul- 
phuric acid and alum are sometimes used, both of which 
are injurious to the stomach. Also through various ma- 
nipulations before it leaves the brewery beer may receive 
an addition of alkali, yeast, sugar or alcohol ; the latter not 
always free from a suspicion of fusel oil. 

In spite of the fact, however, that so much material is 
used in the adulteration of alcoholic beverages, some of 
which is fatally poisonous in small doses, alcohol is the 
poison which inflicts by far the greatest amount of damage 
upon the organism. 

It is highly probable that many of these injurious sub- 
stances, by acting upon the digestive organs and nervous 
system, contribute to the general break down ; but the most 
destructive changes such as interstitial inflammations, de- 
generations and the like, to which so many deaths are due, 
are clearly the result of alcoholic irritation. 



THE CONSTITUENTS OF ALCOHOLIC BEVERAGES. 37 

Malt liquors contain, according to Weiss, the follow 
ing percentages of alcohol : 

Munich beer, 4 varieties, an average of 4.3 

Culmbacher lager beer 4.5 

Porter 5.5-7 

Ale 6.5 

Vienna beer 4.0 

Berlin and Thuringen beer 3.0 

French beer 4.0 

Pilsen beer 3.5 

The average of American beers is probably about 4% 
of alcohol. 

The amount of sugar in different beer varies very 
much, from 3 to 8.5 or 9%. The writer has found the 
German beers much richer in sugar than are those made 
in America. 



III. 

TTbe food Yalue of Hlcobottc Beverages. 

The most important food substance found in alcoholic 
beverages are sugar and dextrine. Sugar occurs in all the 
sweet wines in varying quantity and sugar and dextrine in 
malt liquors. The only other substance which can be re- 
garded as a real food, found in sufficient quantity to de- 
serve notice, is the group of albuminoid bodies derived 
from the malted grain and found only in malt liquors. 
Aside from these two groups of substances alcohol is the 
only material in the ordinary alcoholic beverages in suffi- 
cient quantity to be of importance as a food. 

That alcohol is a food is asserted on every hand but 
still lacks confirmation. From the time that Liebig made 
his celebrated classification of foods until the appearance 
of a memoir by MM. Lallemand, Duroy, and Perrin, it 
was believed that ingested alcohol was totally consumed 
in the body, giving rise to vital energy. The investigation 
disclosed in this memoir showed that alcohol escapes from 
the body unchanged. Not only did they find that alcohol 
escapes unchanged, but that the products of alcohol com- 
bustion, carbonic, acetic, oxalic acid, aldehyde and the like, 
are not increased by alcohol ingestion. 

In more recent times Bodlander (Die Ausscheidung 
aufgenommenen Weingeistes aus der Koerper, Pfluegers 
Archi., XXXII, P. 399 et seq.) expressed the opinion, as 
the result of his investigations, that about 90% of any 
moderate amount of ingested alcohol was oxidized in the 



THE FOOD VALUE OF ALCOHOLIC BEVERAGES. 39 

body to carbon dioxid and water and that the rest, about 
10%, is eliminated as such or as oxidized products of al- 
cohol, through the lungs, skin, and kidneys. These results 
were afterwards corrected by Strassman (Untersuchungen 
ueber den Naehrwert und die Ausscheidung des Alcohols, 
Pfluegers Archi., XLIX, P. 315 et seq.). It was held by 
both that alcohol like every other carbohydrate should be 
regarded as a "respiratory food," that its oxidation within 
the body just like the oxidation of all other carbohydrats 
gave a definite number of caloric units and kept up the 
bodily temperature. In other words it was held that the 
kind of carbohydrate ingested was of no importance so 
long as its oxidation yielded the sufficient number of heat 
units to perform the necessary physiological work and 
keep up the bodily temperature. The fallacy of this meth- 
od of reasoning is pointed out by Dr. August Smith (Die 
Alkoholfrage, P. 12 et seq.) who shows that as a matter of 
fact the most superficial observation will prove that it 
makes a great deal of difference whether alcohol or a like 
quantity of sugar is ingested, and that this difference is due 
to the difference in oxidation. Dr. Smith's observations 
upon this subject are so important that they are given here 
in substance. 

Certain pure chemical observations which have been 
confirmed by physiological researches, but which have been 
neglected or overlooked in the literature of alcohol, com- 
pel a new interpretation of the action of alcohol within the 
living body. 

Alcohol should be regarded as a respiratory poison, if 
the expression can be allowed, because it interferes with 
the interchange of the gases of the entire body by disturb- 
ing the normal life processes of the individual cells. This 
disturbance is produced by the affinity of alcohol for oxy- 
gen, on the one side, and its extreme diffusibility on the 
other. 



40 SHALL WE DRINK WINE ? 

In a general way we must assume that a normal con- 
servation of the bodily temperature must be preceded by 
an equable oxidation process in such a manner that the 
material for consumption through a proper supply of oxy- 
gen shall be submitted to a properly regulated gradual oxi- 
dation, somewhat after the manner of a modern heating 
stove, the fuel of which when thrown in is not immediately 
burned; but, by an intelligently arranged draft, is made to 
do service for a definite time. The sort of coal which is 
appropriate for the stove's system may be regarded, in a 
certain degree, as the nutritious material of the stove, while 
other oxidizable material would produce neither warmth 
nor explosive force. 

Without further argument we may assume that for 
heating our bodies a certain kind of carbohydrate is appro- 
priate, that kind which would make no claim upon nor have 
no need for a greater supply of oxygen than that which is 
furnished by the normal process of respiration, both for 
the purpose of oxidizing the food material and removing 
the carbon gas. 

A superficial consideration will show us that alcohol as 
a "respiratory food" does not answer the purpose of the 
first demand. We have, moreover, sufficient reason for 
holding that a double injury is inflicted by the oxidation of 
alcohol in the body: First, because the increased demand 
for oxygen cannot be supplied through normal respiration 
and, second, that as a result of the increase in carbon 
dioxid, resulting from the rapid oxidation of alcohol, the 
carbon dioxid cannot be promptly removed through ex- 
piration. We have, therefore, to reckon with an active 
and a passive kind of poisoning. The first arises from the 
fact that alcohol leaves the stomach in an extraordinarily 
short time, making a demand for an immediate large 
amount of oxygen which the normal respiratory processes 
cannot furnish. 



THE FOOD VALUE OF ALCOHOLIC BEVERAGES. 41 

The alcohol is, therefore, in part eliminated unchanged, 
but, for some time after its absorption, it must remain in 
contact with the tissues, awaiting a supply of oxygen or a 
removal to some organ through which it may be elimi- 
nated. The respiratory organs make an effort to supply the 
increased demand for oxygen, for the experiments of 
Zuntz (Beitrag zur Kenntn. d. Wirkung des Weingeistes 
auf. d. Respirationsproz. d. Menschen; Zeitsch. d. Med. 
i887,S.I.) show that there is a reflex increase in the amount 
of air inspired amounting to 9% and by Geppart (Die Ein- 
wirkung d. Alk. auf d. Gaswechsel d. Menschen, Archiv. f. 
exp. Path. u. Pharm. 1887 Bd. XXII, P. 368.) the in- 
crease was found to be 7%. In spite of this reflex in- 
crease, however, the experiments of Wolffer have shown 
that the supply of oxygen is still insufficient to meet the 
increased demand, whenever alcohol is introduced into the 
animal organism. In alcoholized rabbits, with which Wolf- 
fer experimented, in spite of the fact that the gasometer 
showed they were obtaining a larger supply of oxygen 
than when other carbohydrate food was given, the respir- 
atory quotient remained relatively higher, approaching or 
passing unity. Thus, for alcohol, the respiration quotient 
(i. e. for every CH combination there is a constant rela- 
tion between the excreted carbon dioxid and the in- 
spired oxygen) is exactly two-thirds (C 2 H 6 0-{-6o= 2 C0 2 
3H 2 0), therefore the increase in the output of carbon 
dioxid is to be explained in two ways: First, that other 
carbohydrate of a higher respiratory quotient are oxidized 
with the alcohol, and this is the explanation accepted by 
Wolffer, in spite of the fact that his experiments were 
carried out with rabbits which had fasted for a long time, 
or, and this certainly seems the most probable explanation, 
the alcohol not finding a sufficient supply for oxidation in 
the circulating oxygen, must, from every tissue with which 



42 SHALL WE DRINK WINE? 

it comes in contact, take up the oxygen which is necessary 
to the cell in carrying out its functions. 

The affinity of alcohol for oxygen explains the cell de- 
generation which is found in cases of acute fatal alcoholic 
poisoning. This degeneration is seen in nearly every or- 
gan of the body, but is particularly typical in the cells of the 
absorption vessels, especially those of the liver (Hankel, 
Vergiftung d. einmal, Genuss d. Alk. Vierteljahrschrift ger. 
Med. N. F. XXXVIII, I, P. 15, et seq.). So also have 
Nissl and Dehio shown this kind of cell degeneration at- 
tending alcohol poisoning, especially in the cells of the 
brain. 

We see, therefore, that while the oxidation of alcohol 
within the body may give rise to a certain amount of heat, 
the circumstances attending its oxidation remove from it 
all claims as a food material. Still more shall we be justi- 
fied in denying it food properties when we remember that 
the increased bodily temperature lasts for only a single mo- 
ment Within two or three minutes after its ingestion 
paralysis of the peripheral nerve endings cause a dilatation 
of the surface blood vessels, giving rise to increased heat 
radiation; so that though the total amount of bodily heat 
may for a short time be increased, the increase in heat 
radiation more than compensates for the increased pro- 
duction, so that the actual temperature of the body is 
lowered after the imbibition of even very small quantities 
of alcohol. 

The amount of alcohol which may be oxidized within 
the body certainly must be small even under the most fa- 
vorable circumstances ; for, no matter how small the quan- 
tity taken, some of it is eliminated unchanged. Nor is 
there any definite evidence that the ingestion of alcohol is 
followed by an increase in the elimination of incompletely 
oxidized products of alcohol, such as acetic and oxalic 
acids. 



THE FOOD VALUE OF ALCOHOLIC BEVERAGES. 43 

Nor is the increase in carbon dioxid excretion by any 
means constant. The narcotic effects of alcohol upon the 
respiratory center soon decreases its irritability to such an 
extent that it no longer responds to the irritation of an in- 
creased amount of carbon, and the respirations become 
slower and shallower, further contributing to the general 
embarrassment of the vital functions. The reason why so 
many investigators have arrived at different results or why 
the same investigator has arrived at different results at dif- 
ferent times, is probably due to the amount of alcohol 
given in the experiments. Naturally, we would expect an 
increase in the excretion of carbon dioxid when an amount 
of alcohol insufficient to narcotize the respiration center 
had been given, and a decrease in carbon dioxid excretion 
when a greater amount had been exhibited. 

Dr. Adolph Fick, the celebrated professor of physi- 
ology in Wurzburg, gives the following estimate of alcohol 
as a food (Die Alkoholfrage, P. 5 et seq.). 

"The oxidation of proper food material, albuminoids, 
fats, and sugar, has not for its principal object the genera- 
tion of heat; but the maintenance of the functions of the 
muscles, the nerves, and the gland cells, in short, the activ- 
ity of the entire tissues of the body. The animal organ- 
ism is, in this respect, to be compared with a steam engine. 
If it is to do work it must be furnished with a definite sort 
of fuel put in a certain place through which mechanical 
power is generated; and at the same time, heat developed. 
Certainly alcohol cannot be regarded as an efficacious food 
for muscles, nerve cells, and the like. Not even in a nar- 
row sense can it take the place of a force generating food 
stuff. It might be supposed that the heat generated by the 
oxidation of alcohol would be of value to the organic 
household, outside of the question of organic activity, in 
keeping up the bodily temperature in the colder surround- 



44 SHALL WE DRINK WINE? 

ing medium. This, however, is not correct, and for two 
good reasons: First, alcohol greatly increases heat radi- 
ation by dilating the blood vessels of the skin, which be- 
comes reddened through this increased blood supply. This 
gives rise to the deceptive subjective feeling of warmth, but 
according to physical laws the warm skin gives out more 
heat into the colder surrounding atmosphere, and the 
bodily temperature, according to abundant experimental 
proof, is actually lowered by the ingestion of alcohol. 
Secondly, the oft repeated statement that alcohol, when in- 
gested, being much more easily oxidized than the tissues 
of the body, is burned up while the body tissues are spared. 
But this has not only been shown to be not true, but ex- 
periment has shown that alcohol actually hastens bodily 
tissue waste. 

Although the oxidation of alcohol in comparison with 
the oxidation of true food materials in the animal organism 
is not yet completely cleared up, it is certain that alcohol in 
moderation cannot be counted as a proper food material. 
All the pleasant sensation of physical and mental strength 
brought forth by moderate doses of alcohol are deceptive 
and depend upon paralysis of the critical judgment and 
upon the momentary blunting of the sensation of fatigue." 

The oft repeated statement that alcohol prevents nitro- 
genous tissue waste is by no means proven. Miura (Zeit- 
schrift f. Klin. Medicin, 1892, vol. XX, P. 137.) in a series 
of elaborate experiments, referred to by Professor Fick, 
arrived at diametrically opposite results. He brought 
himself into a condition of what is known to physiologists 
as "nitrogenous equilibrium," that is he took just enough of 
a mixed food to keep him at a definite weight. Then he 
omitted from his diet a certain part of the carbohydrate 
food, and substituted an equal (isodynamic) amount of al- 
cohol. The alcohol, however, did not give the expected 



THE FOOD VALUE OF ALCOHOLIC BEVERAGES. 45 

protection ; for there was proteid loss from the body, show- 
ing that the alcohol did not act as a food. He then re- 
sumed his old diet until a nitrogenous equilibrium was 
again established and again left out from his diet the same 
part of the carbohydrate material but did not substitute al- 
cohol. During this period it was found that less proteid 
was lost from the body than during the time that alcohol 
was also taken, thus showing that instead of protecting the 
bodily tissues against waste by its oxidation, it exercised a 
directly injurious effect on proteid consumption. 

Dr. Diakonoff of St. Petersburg (Wratch, 1889) carried 
out some experiments to show the effects of alcohol upon 
febrile patients which are of interest in view of the oft re- 
peated statement that alcohol is a valuable auxiliary food, 
especially in typhoid fever. Of the seven patients subjected 
to experiment, six had typhoid fever and one exudative 
pleurisy. Five were moderate drinkers and two were to- 
tal abstainers. The alcohol was given in the form of 40% 
vodka, in amount about one and three-fifths ounces of ab- 
solute alcohol daily. No other medicines were adminis- 
tered and the food was limited to white bread and milk. 

He found that alcohol invariably lowers the assimila- 
tion of nitrogenous food and that there was no difference 
in this respect between the habituated and non-habituated 
patients. This interference with proteid assimilation was 
manifested by a largely increased amount of undigested 
albumen in the faeces, and unoxidized products in both the 
faeces and urine. 

It has been shown, moreover, by Bunge (Lehrbuch der 
phys. und path. Chemie., Leipzig, 1889, P. 348 et seq.) that 
the carbohydrates are the chief source of muscular 
strength; and Mosso (Infleuenza dello zucchero sul lavoro 
dei muscoli-Ugolino Mosso and Luigi Paoletti) has dem- 
onstrated the stimulating effects of an easily absorbed so- 



46 SHALL WE DRINK WINE? 

lution of sugar upon muscular contractions. Certainly if 
alcohol has anything of food value in common with other 
carbohydrates its effects upon muscular contraction should 
be like those of sugar, in kind if not in degree. On the 
contrary, however, the experiments of Dr. Frey (Ueber 
den einfluss des Alkohols auf die Muskelermueding) show 
conclusively that the total capability of the muscle is very 
much lessened by the ingestion of even small quantities 
(two and one-half to five grams) of alcohol. 

In the light of the foregoing definite experimentation 
and observation the reiterated statements so widely preva- 
lent in authoritative medical literature that alcohol fur- 
nishes an easily oxidizable food which makes it of value 
whenever immediate vital force is desired or to prevent tis- 
sue waste in disease, should be at once and for all time dis- 
carded as untrue. 

Returning to the subject of the food value of alcoholic 
beverages as a whole, the spirituous liquors may be elim- 
inated at once as having no value; because they contain 
practically nothing but alcohol and water. Some wines 
contain sugar, varying in this respect from two or three 
per cent, to twenty-five per cent, or more. No one, how- 
ever, will ever buy a bottle of the sweetest wine for its 
food value as long as bread may be had for five cents a 
loaf and sugar for six cents a pound. 

We hear a great deal about the food value of beer and 
other malt liquors. Much is said of the highly nutritious 
"extractive" substances found in malted grain and held in 
solution in beer and ale. Many persons who make or echo 
those encomiums on beer forget, or never learned, that 
good bread possesses all those extractives. Moreover, 
beer as a food compared with bread is extraordinarily dear. 
In Germany where the best beer can be bought at the rate 
of four liters or a little over one gallon for one mark (24 



THE FOOD VALUE OF ALCOHOLIC BEVERAGES. 47 

cents), Struempell estimates that it costs about eight times 
as much as would be asked for an amount of bread con- 
taining an equal amount of nutrition, and that the differ- 
ence is still greater in comparison with potatoes, peas, 
beans or other vegetables. He estimates that four liters 
of beer contain 240 grams of carbohydrate food and scarce- 
ly 32 grams of albuminoid material, while bread purchased 
for one mark contains 2,000 grams of carbohydrate and 
250 grams of albuminoid food. In America bread can be 
bought as cheaply as in Germany, but beer costs the Amer- 
ican consumer probably twice as much; so the American 
laboring man pays about twenty times as much for the 
food he obtains in beer as that which he obtains in his 
bread. Moreover, German beer is much richer in sugar 
and other extractive matter than that made in our own 
country, and is probably not adulterated to the same ex- 
tent; for all beers made for domestic consumption in Ger- 
many are subjected to an examination by a state chemist, 
penalties being imposed upon the manufacturer if his prod- 
uct is not up to a certain standard, while in America no 
such system is in force. We may, therefore, without fur- 
ther consideration, decline to regard alcoholic beverages 
as foods. 



IV* 
Hlcobol as a Stimulant. 

From time immemorial alcohol has been used as a 
stimulant. The term stimulant has been rather loosely ap- 
plied; but it is supposed to mean a substance which in- 
creases mental and physical capacity to perform work, to 
enhance, in short, the value of all vital functions, espe- 
cially those of the heart. Exhaustion results from the lack 
of suitable food to renew the worn out tissues or from ex- 
cessive work on the part of the exhausted organ, more tis- 
sue being consumed than can be supplied. An easily di- 
gested and assimilated food, with rest, are the prime stimu- 
lants when the heart's power is unimpaired through or- 
ganic disease. Any remedy increasing the systolic power 
of the heart without increasing its frequency is the best 
stimulant when that organ alone is responsible for the ex- 
haustion. In order to make plain all sources of exhaustion 
the fact that the heart's action is often notably depressed by 
a multitude of nervous reflexes must not be forgotten. One 
of the most common is that observed in the condition 
known as shock, resulting from severe injury, pain, or 
overwhelming mental impressions. In these conditions 
whatever will lessen the sensibility of the nervous system, 
will act as a stimulant. Here morphine and other nar- 
cotics act as stimulants by removing the reflex irritation 
which depresses the heart's action. 

If the above propositions are well founded, and they 
seem to be, the value of alcohol as a stimulant may be de- 



ALCOHOL AS A STIMULANT. 49 

termined by comparing its physiological effects with the 
requirements of a stimulant above indicated. 

So many observers have noted a temporary increase in 
the force and frequency of the heart beat after the ingestion 
of moderate doses of alcohol, that the correctness of these 
observations cannot be doubted. The period over which 
alcohol exercises a stimulating effect upon the heart, is, 
however, very short; for, as has been shown by Smith 
(Loc. Cit.), it lasts only until the superficial blood vessels 
are dilated by the paralyzing effects of alcohol upon the 
paripheral nerves. The effects of alcohol upon the ex- 
hausted or fatigued heart muscle may be better understood 
after studying the effects of alcohol upon muscular work 
in general. 

Exact experimentation to determine in what manner 
and to what degree muscular contraction is influenced by 
alcohol was first carried out, so far as I am aware, by Dr. 
Herman Frey, in Professor Sahli's medical clinic in Bern. 
His report was published in a pamphlet in 1896 under the 
title of "Ueber den Einfluss des Alkohols auf die Muskel- 
ermudung." Mosso's "Ergograph" was used to register 
the amount of work done, from the time the contractions 
began until they ceased from muscular exhaustion, was es- 
timated in kilogram meters. Experiments were made 
with the muscle in a fresh condition after a long period of 
rest, and after it had been fatigued by repeated contractions. 
Alcohol was given in the form of cherry brandy, cognac, 
wine, beer and diluted alcohol, the cognac and cherry 
brandy being also diluted, and in amount equal to from 
one and one-fourth to two and one-half drachms of abso- 
lute alcohol. 

Upon the unfatigued muscle these small doses of alco- 
hol, with only two exceptions, m one, that of a hysterical 
man, decreased muscular capability. Not only were the 



50 SHALL WE DRINK WINE? 

individual contractions weaker under the influence of alco- 
hol, but the total amount of work performed before the 
muscle became exhausted was much less when alcohol was 
ingested. For instance, in one case the total work without 
alcohol was 4.66 kilogram meters ; but, under the same cir- 
cumstances, twenty minutes after drinking a little over a 
half pint of beer, the total amount of work was only 2,66 
Kilogram meters. In a second case the total work per- 
formed by the muscles tested was 4. 11 and 4.8 kilogram 
meters in two tests, while a third test made ten minutes 
after the ingestion of a little over a pint of beer, showed a 
total efficiency of only 2.63 kg. meters. A third 
subject gave 4.79 and 4.58 kg. meters respectively 
in two tests without alcohol, and only 2.02 kg. 
meters in a test made fifteen minutes after drinking about 
a half pint of beer. Several other subjects gave similar 
results. In one case the total amount of work was in- 
creased from 5.95 to 6.35 kg. meters to 8.6 kg. 
meters ten minutes after the ingestion of a half pint of beer. 
The author thinks, however, that this subject, as well as 
the hysterical patient, was influenced by suggestion. The 
results were the same whether brandy, wine, beer or di- 
luted alcohol was exhibited. 

A peculiar fact was to be noted during the experiments 
which explains the almost universal belief among alcohol 
drinking laymen, and among medical men as well, that al- 
cohol gives strength. In spite of the fact that the maxi- 
mum contractions were weaker and the muscles became 
fatigued sooner under the influence of alcohol, the subject 
lifted the weight without as much conscious effort after 
taking the alcohol as before. In the case of the author 
himself this difference was so marked that he was obliged 
to examine the apparatus to see whether some of the 
weight had not been removed, so much easier did he find 



ALCOHOL AS A STIMULANT. 51 

the work after drinking a small quantity of alcohol, at the 
same time he was actually doing less than before the al- 
cohol was ingested. 

From these experiments, therefore, the author draws 
the following conclusions: 

1. Alcohol has an injurious effect upon the unfatigued 
muscle, in that it essentially decreases the amount of work 
the muscle is capable of doing. 

2. The feeling of fatigue is abolished by alcohol and, 
for this reason, the labor seems to be lighter. 

The subjects of Dr. Frey's experiments seem to have 
all been men accustomed to a moderate amount of alco- 
holic drink daily. He remarks, however, that in his own 
case the effects of alcohol in decreasing muscular capabil- 
ity were most marked after six weeks of total abstinence 
from all kinds of alcoholic drink. 

To determine the effects of alcohol upon fatigued mus- 
cle, experiments were carried out in the following manner : 
A series of contractions were inaugurated in each of which 
the muscle was completely exhausted, and the time between 
each series was so short (from one to three or five minutes) 
that the muscle was not completely rested before the be- 
ginning of the next series. The contractions thus produced, 
in a short time, a condition of complete exhaustion, finally 
rendering the muscle unable to respond to the stimulus at 
the end of the short period of rest. 

When complete exhaustion was thus brought about 
the exhibition of the same small quantity of alcohol as was 
given in the experiments with non-fatigued muscle, en- 
abled the muscle to make renewed effort. The total 
amount of work which the muscle could accomplish, af- 
ter the subject had ingested the alcohol, was estimated by 
the author to be equal to the amount done before complete 



52 SHALL WE DRINK WINE? 

exhaustion by the non-alcoholized muscle; but in no case 
did the individual contraction after alcohol ingestion rise as 
high as they did in the absence of the alcohol. For in- 
stance, in one case the work accomplished before complete 
exhaustion equaled 3.35 kg. meters, when 15 grams of 
cognac were given. The muscle then accomplished 3.6 
kg. meters before the occurrence of complete exhaustion. 
Similar results were attained in other cases. As a rule, 
however, the amount of work accomplished after alcohol 
ingestion was less than before. 

It is to be noted here as a matter of much importance 
that massage had a similar influence nearly as great as that 
shown by alcohol, and the same exhibition of renewed con- 
tractile power followed the ingestion of 20 grams of sugar 
in watery solution. For instance, the total labor of a mus- 
cle before exhaustion equaled 1.95 kg. meters and 
after two minutes' massage was stimulated to renewed ef- 
fort equaling 1.68 kg. meters. Similarly a case is 
recorded by Dr. Frey in which the total amount of muscu- 
lar work before complete fatigue equaled 2.85 kg. 
meters, when 20 grams of sugar brought about renewed 
efforts, in which 2.55 kg. meters of work was accom- 
plished by the same muscle before complete exhaustion 
again occurred. 

By what means then does alcohol bring about renewed 
activity in the fatigued muscle? Not as a food certainly, 
or it would not have the injurious effects on non-fatigued 
muscle shown in the first series of experiments. Or if it 
has a food value, that is entirely smothered by its narcotic 
effects. According to Bunge (Loc. Cit.) the carbohy- 
drates are the chief source of muscular strength. We 
would expect, therefore, that an exhausted muscle would 
be stimulated to renewed activity by the absorption of 
sugar. The effect of massage is not so clear. It might 



ALCOHOL AS A STIMULANT. 53 

operate by increasing the circulation and thus enable the 
muscle to get rid of irritating waste products, and probably 
does act in that way. 

Alcohol, however, has the power to both irritate and 
narcotize. Does it, then, affect the fatigued muscle by 
goading it to renewed efforts simply as a chemical irritant, 
or does it make further contraction possible by neutraliz- 
ing the effects of tissue metabolism which are known to 
produce fatigue or, furthermore, does the small amount of 
alcohol given in these experiments of Dr. Frey lower, for 
a time, the rate of tissue metabolism, while it hastens the 
departure of waste products by peripheral dilatation of the 
blood vessels? None of these questions can be answered 
at the present time. 

As to whether the fatigued muscle thus temporarily 
aroused by alcohol was thereby rendered incapable of per- 
forming the normal work of the unfatigued muscle, after 
the same period of rest, was not determined by Dr. Frey. 
He states merely that the alcohol seemed to have no dele- 
terious effects. 

Experiments were carried out with the electric current 
as an irritant, giving the same results as when contraction 
was voluntary. 

It is entirely reasonable to suppose that alcohol affects 
the fatigued heart as much as it does muscles of the volun- 
tary system, either by inhibiting the results of fatigue by 
peripheral narcosis, if the term may be allowed, or by spur- 
ring it on to renewed efforts simply as an irritant. That 
alcohol affects the heart directly and not through the cen- 
tral nervous system has been pointed out by Dr. David 
Cerna (Therapeutic Gazette, April, May and June, 1894). 
That alcohol stimulates by inhibiting the effects of fatigue 
irritation, is indicated by the experiments of Dr. H. C. 
Wood (Medical News, Vol. 57, p. 126) with alcohol in 



54 SHALL WE DRINK WINE ? 

chloroform and ether narcosis. His statements are as fol- 
lows: 

"Of all drugs that which I think is usually most relied 
upon by clinicians as a cardiac stimulant in anaesthesia, as 
in other cases of heart failure, is alcohol. The chemical 
and physiological relation of alcohol to ether and chloro* 
form are, however, so close that many years ago I became 
very doubtful of the value of this drug as a stimulant to a 
heart depressed by anaesthesia. 

These doubts continually grew stronger from what I 
saw and read as to the effects of the administration of al- 
cohol during anaesthesia, and were finally changed into 
conviction by the experiments of R. Dubois (Progres 
Medical, 1883), who found that in the animal to which al- 
cohol has been freely given, much less chloroform is re- 
quired than in the normal animal, to anaesthetize or to 
kill; or, in other words, that alcohol intensifies the influ- 
ences of chloroform and lessens the fatal dose. 

"In my own experiments with alcohol an 80 per cent, 
fluid was used, diluted with water. The amount injected 
into the jugular vein varied in the different experiments 
from 5 to 20 c.c. ; and in no case have I been able to detect 
any increase in the size of the pulse or in the arterial pres- 
sure, produced by alcohol, when the heart was failing dur- 
ing advanced chloroform anaesthesia. On the other hand, 
on several occasions the larger amounts of alcohol 
apparently greatly increased the rapidity of the fall of the 
arterial pressure, and aided materially in extinguishing the 
pulse rate." 

We might interpret these results by saying that, with a 
heart already narcotized, stimulation by abolishing fatigue 
irritation is not possible as it has already been abolished, 
and that the narcotic effects of alcohol would be manifest 
only in increasing the profundity of existing narcosis. 



ALCOHOL AS A STIMULANT. 55 

The beneficial effects to be observed from the giving of 
alcohol in conditions of shock, depend but very little, it is 
probable, upon its direct stimulation of the heart. The 
condition itself is brought about by some overwhelming 
impression made upon the central nervous system. Great 
joy, fear or other emotion is well known as a cause of fatal 
shock. On the other hand profound shock arises from 
purely physical causes, like the destruction of large sensory 
areas by extensive burns or the severing of the nerve 
trunks supplying these areas in high amputations of the 
lower limbs. In section of the optic nerve during enuclea- 
tion there is a momentary profound shock during which 
the pulse disappears at the wrist. The amount of alcohol 
found necessary to bring about a reaction in these cases is 
much more than that which is found sufficient to raise 
arterial pressure. Those who have employed whiskey or 
brandy for this purpose will recall that two or three or more 
ounces may be given a patient before signs of reaction 
become manifest. It would seem, certainly, that the nar- 
cotizing effect of these large doses would have much more 
to do with relieving shock by rendering the nervous sys- 
tem unimpressionable than by stimulating the action of 
the heart directly. Opium and other narcotics promptly 
increase the action of the heart in the same way. 

An abundance of experience under widely differing cir- 
cumstances of climate, involving equatorial and polar ex- 
tremes of temperature, have unanimously shown that the 
hardships of exploration, military campaigning, hunting, 
and all other adventures of like nature are not only in no 
way lightened by alcoholic ingestion but that dependence 
upon this so called "stimulant" has always been attended 
by disaster whenever the greatest physical efforts were to 
be put forth. 

Experience in the army of the United States has shown, 



56 SHALL WE DRINK WINE? 

according to Dr. Frank H. Hamilton, that the habitual use 
of no amount of alcoholic liquor by healthy men is to be 
advised under any circumstances. No exception should 
be made whatever for extreme heat or cold, rain or shine, 
nor whether the soldier had been accustomed to drink be- 
fore entering the army. Even the moderate drinking of 
alcoholic liquor has been shown to be so injurious to those 
who are subjected to the hardships of life, in an arctic cli- 
mate, that shipmasters, in the last ten or fifteen years, have 
absolutely forbidden the use of any kind of spirits to the 
crews of ships coming in polar waters. Nansen ascribed 
his successful journey across Greenland on snowshoes to 
the fact that he and his companions had not a drop of al- 
cohol with them. The same holds good, but probably in 
a lesser measure, for tropical climates as has been shown 
by the experience of the British Army in East India. 
Moreover Karl Peters had a similar experience in East 
Africa. He says, in his work upon the German Emin 
Pascha Expedition, p. 268: "In Baringo the last bottle 
of cognac was destroyed. After this we had coffee, tea 
and cocoa to drink, and it may also be said that our 
health became excellent." 

Certainly the proper test for a muscular stimulant is its 
use in just the hardships above enumerated. Failing to 
meet those requirements and indeed adding physical 
demoralization to the hardships already incurred, where 
is the ground for saying that alcohol is a muscular 
stimulant? 

That alcohol promotes a "flow of ideas" is a postulate 
held by the majority of medical men. In the absence of 
definite proof to the contrary it is easy to understand that 
an increased flow of words might be mistaken for an actual 
gain in thought. By no investigators, as far as I know, has 
this matter been so thoroughly studied as by Kraeplin (Der 



ALCOHOL AS A STIMULANT. 57 

Physolog. Versuch in der Psychiatrie, Leipzig, 1895 and 
Ueber die Beeinflussung einfacher phychischer Vorgaenge 
durch einige Arzneimittel, Jena, 1892). The results of 
Kraeplin have been summarized by Dr. August Smith 
(Loc. Lit.) as follows : 

"The action of alcohol upon mental processes, the re- 
sults of which are so evident in acute alcoholic intoxication 
or drunkenness, as well as in the later stages of chronic al- 
coholic poisoning, deserve especial consideration. Kraep- 
lin was the first to make the study of psychic processes of 
value in practical medicine, especially in psychiatrie. This 
he did after the method of Wundt, and we have him and 
his school to thank for a series of valuable conclusions as 
to the action of special poisons upon the psychic domain. 

"Especially have we a series of his observations regard- 
ing alcohol poisoning which give us a very good under- 
standing of the complicated processes involved, although a 
final determination of the same is not yet reached. The 
difficulty of arriving at definite conclusions is based upon 
the essential difference in the manner in which moderate 
quantities of alcohol affect the intellectual and motor 
centers. 

"It has been proven experimentally that all the intel- 
lectual functions examined suffer a marked depression 
after the ingestion of small, moderate and large doses of 
alcohol, and that this depression makes its appearance im- 
mediately after the alcohol has been ingested, as a rule. 
In a few cases there appeared to be a short period of in- 
creased activity; but in these cases the amount of alcohol 
given was so small that this fact cannot be said to have 
been established. At the same time that the intellectual 
functions were depressed there was an increased activity in 
the motor functions which was followed, after a short time, 
by depression. Different psychic functions, in which mo- 



58 SHALL WE DRINK WINE? 

tor actively played a role indicated these double effects very 
beautifully. When, for example, in the case of associa- 
tions in which the reaction periods become shorter, that is 
the quantity of the associations increased, while their char- 
acter became entirely different. Instead of the inner as- 
sociations the outer ruled, instead of ideas connected in 
their logical relations, word memory and tune, rhyme and 
assonance became more prominent as is seen in cases of 
dementia in the human subject. 'More words but fewer 
ideas/ » 

Kraeplin speaks of tHe results of his psycho-physical 
experiments in the effects of acute alcoholic intoxication 
and their relation to what is already known of the subject 
as follows : 

"Let us again cast a look upon the completed picture of 
alcohol intoxication which we have attempted to develop 
by our experiments, and there can scarcely be any doubt 
that it possesses the same features which have become so 
well known to all of us through daily experience. The ex- 
periments give us the same appearances, though in a 
milder degree, which we observe in the brutality of the se- 
vere acute alcoholic poisoning. The difficulty of compre- 
hension seen in the subjects of our experiments corre- 
ponds with the inability of the drunkard to follow the 
course of events in his immediate vicinity, and to properly 
conduct himself in relation to the same. This difficulty in 
arousing his attention exists in all degrees up to the point 
where there is complete insensibility resulting from blunt- 
ing of all the organs of sense. In the retardation of the 
associative processes we again see the depression of his in- 
tellectual functions, the abolition of discriminative power 
which makes it impossible for him to impart or receive an 
idea, the lack of which makes it impossible for him to tell 
whether the idea is his own judgment or that of another, 



ALCOHOL AS A STIMULANT. 59 

the poverty of clear estimation and insight into the range 
of his words and acts. The qualitative changes of the 
associations are signalized to us by the superficiality of the 
thought range, the tendency to stereotyped and trivial 
phrases, to empty jests, to foolish repetitions, sometimes 
in a foreign language. 

"The stimulation of the motor reactions is the ultimate 
source of the sensation of increased strength, and also of all 
those thoughtless, purposeless, impulsive and violent acts, 
which has given alcohol such notoriety, not only in the his- 
tory of foolish and thoughtless acts, but also in the annals 
of criminal impulses. It is the source of that lack of self- 
restraint which is seen in a company of drunken revelers 
among whom some catch word or some act may be the 
signal for all such purposeless and thoughtless reactions as 
foolish talkativeness, shouting, singing, screaming, decla- 
mation and the like; and corresponds to what our experi- 
ments showed when the difficulty of thinking had become 
marked. With this phase of alcoholic intoxication should 
be pointed out the fact that under its influence all psychic 
restraint, which is known to us as timidity, embarrassment 
and confusion, is abolished, that all those countless consid- 
erations which govern our conduct in our relation with our 
fellows, in the normal state, lose their power over us. We 
become courageous, unrestrained, and regardless of conse- 
quences, we speak without thought, express ourselves un- 
couthly without troubling ourselves as to the effects of 
what we say, and tattle our secrets nonchalantly alike to 
intimate friends or strangers. 

This increased activity in the motor sphere and eu- 
phoria of the drunkard, Kraeplin ascribes to the subjec- 
tive feeling of increased strength. 

While Schmeideberg and Bunge look upon this motor 
excitement as the result of paralysis of the intellectual pow- 



60 SHALL WE DRINK WINE? 

ers and would make the lack of judgment in the psychic 
direction answerable for all the purposeless motor im- 
pulses, somewhat like that which is seen in excessive ataxic 
movements of tabes. Kraeplin thinks it is due to the dif- 
ferent manner in which alcohol affects the motor and sen- 
sory centers. 

"We come, therefore, to the conclusion that alcohol, as 
a matter of fact, affects both sides of our soul-life, but each 
in a different manner. With large doses the sensory and 
intellectual as well as the motor functions are quickly 
paralyzed. Small doses, on the contrary, abolish only the 
first, while upon the latter domain the paralysis is pre- 
ceded by a longer or shorter stage of excitement." Kraep- 
lin also attributes a greater resistance to the motor centers 
against the power of alcohol poisoning. 

What the euphoria of the drunkard most nearly ap- 
proaches is erethistic imbecility. In both there is that 
naive self-glorification with progressive liability toward 
brutality, so much said by both drunkard and imbecile 
about what he has seen and experienced, and the same un- 
shakable confidence in his own powers. In drunkenness 
there is a lack of the critical powers for which the ex- 
tinguishment of the judgment is responsible, and I could 
without further discussion point it out as analogous to the 
foolish happiness of the weak minded. 

Further, there can be no doubt that different centers of 
our brain possess different degrees of resistance. If we 
refer to the beautiful diagrams of Exner, it will be made 
clear to us, that those lines of action which are first to de- 
velop in the life history of the individual are for that rea- 
son the strongest and the least easily disturbed in their re- 
lation to others. It, therefore, needs no complicated the- 
orem to demonstrate that the motor centers and those 
which control purely vegetable processes which serve to 



ALCOHOL AS A STIMULANT. 61 

perpetuate the individual and the species, provide for the 
carrying out of their functions over established routes in 
quite a different manner from that of those centers the de- 
velopment of which is the result of social-ethical education 
which comes with more mature years. And, furthermore, 
that it is just these last developed social-ethical feelings 
which are first to suffer a blunting or complete extinguish- 
ment in chronic alcoholism is a well known fact. 

But something further in this apparent opposition be- 
tween the intellectual and motor sphere seems to me to de- 
serve consideration. 

That is the fact that with the cessation of psychic pro- 
cesses involuntarily the motor functions are set free. Som- 
mer pointed out at the meeting of naturalists and physi- 
cians in Vienna in 1894, that in the Westphal phenomenon 
with the balanced leg, at the moment of the falling of the 
hammer in Jendressek's grasp a higher level was reached; 
in other words, that the energy which was applied to the 
hand grasp, probably because of the expectation effect 
through the attention being given to the hammer, at the 
moment the blow was interrupted, involuntarily it was 
transposed into muscular activity, which caused the leg to 
be actively raised for quite a long time. 

The remarkable antagonism between morphine and al- 
cohol poisoning seems to me to be a far reaching support 
for the presence of a law, also, for the conservation of 
power in the brain mechanism, where a sudden transmis- 
sion of a cortical stimulation in some way seems to have 
an inductive influence upon the sub-cortical centers. As 
we have seen after the ingestion of alcohol there is an im- 
mediate blunting of the intellectual processes followed by 
an increased motor activity; but, with the ingestion of mor- 
phine in the abstinent, whatever increased motor activity 
may be present is diminished and intellectual capacity is in- 



62 SHALL WE DRINK WINE? 

creased. We have analogous phenomena in mania, in the 
excitement of febrile diseases with disturbances of con- 
sciousness, and others. 

The experiments of Professor Kraeplin in showing" the 
effects of small quantities of alcohol (one and one-fourth 
to two and one-half ounces daily, in divided doses) upon 
the psychic functions are of extreme interest and impor- 
tance and conclusively demonstrate the injurious effect of 
alcohol upon the mental functions. It should not be for- 
gotten that the amount of alcohol used by Kraeplin is just 
the amount which nearly every medical writer on the sub- 
ject has declared may be disposed of without injury, or 
with benefit, by the ordinary adult, daily, if given in divided 
doses, properly diluted. In this manner it was given by 
Kraeplin. 

The experiments extended over a period of twenty- 
seven days. Mental capability was tested in two ways, by 
problems in addition and by memorizing. The capability 
for this sort of brain work was first tested without alcohol 
and as will be seen in the figures, (i and 2) with slight 
vacillations, there was a daily increase of efficiency. 

The alcohol was then given when, for a few days, the 
mental capability remained at nearly the same level, then 
greatly and rapidly decreased, the decrease being much 
more noticeable in the case of the ability to memorize. 
After the breaking off of the alcohol there was an imme- 
diate rise of efficiency which continued for seven days. 
On the eighth day the exhibition of the alcohol was re- 
newed and immediately there was a great depression in 
this form of mental capability. It will be observed by re- 
ferring to the figures that the depression was much more 
rapid after the renewal of the alcohol following the seven 
days of abstinence. It would seem from these experiments 
that even this so-called small amount of alcohol first par- 



FIG. 1. 




Exercises in Addition. 



The black spaces represent the days upon which alcohol was taken, 
and their height the proficiency which the subject experimented with 
reached in the two mental processes. Figures to the left indicate number 
of Tests. 



FIG. 2. 




Exercises in Memorizing (Ad. from Dr. Smith). 

The black spaces represent the days upon which alcohol was taken, 
and their height the proficiency which the subject experimented with 
reached in the two mental processes. Figures to the left indicate number 
of Tests. 



ALCOHOL AS A STIMULANT. 63 

alyzes the brain protoplasm, rendering it incapable of re- 
ceiving lasting impressions in a normal degree; and that 
with continued use, the paralysis is followed by degenera- 
tion. 

The same experiment was carried out by another in- 
vestigator for a period of twenty-two days, and though 
there were individual differences due to various causes the 
same result was always observed, that is, an important 
lessening of mental capability during the ingestion of 
alcohol, and a relatively more rapid decline in mental 
cabability upon resuming the alcohol after a seven days' 
abstinence. 

Another series of experiments were carried out to de- 
termine the effect of this amount of alcohol upon the length 
of the period between stimulation and reaction, with the 
result of showing that this period was always lengthened 
by the use of alcohol. 

Still more significant were the conclusions arrived at 
through a series of experiments conducted by Dr. Smith 
himself (Die Alkoholfrage, P. 30 et seq.). He undertook 
the task of determining what mental processes were most 
affected by alcoholic poisoning. For this purpose he fol- 
lowed the arrangement of Aschaffenberg, which classifies 
mental processes as follows: 

1. Internal Associations : Co-and subordination, casual 
dependence associations, predicative determination. 

2. External Associations: Co-existence of time and 
place, identity, speech reminiscences. 

3. Disconnected Perception Associations: Word-Sup- 
plementing or completion, tune and rhyme Associations, 
wholly unintelligible association. It will be observed that 
the first group of associations have to do with the judg- 
ment, the grouping together of ideas and drawing con- 
clusions therefrom ; the second has to do with the memory, 



64 SHALL WE DRINK WINE? 

upon recalling matters in logical sequence, while the last 
is a mere matter of memory without judgment and with- 
out any logical sequence of events. 

The following diagram shows (Fig. 3) Dr. Smith's 
method of determining the relative number of associations 
in each group estimated on a percentage basis. A total 
of 1,350 Associations was examined and classified. Ex- 
amining the diagram it will be seen that the internal and 
external associations are almost equal, while those of the 
last group are so few as to be of no practical importance, 
during the period of abstinence from alcohol, 1-5 days. 
During the period of alcohol ingestion (40 to 80 grams 
being taken), extending over eleven days, the number of 
internal associations markedly decreased while the external 
group increased in the same proportion, and there is a 
relatively very large increase in the lowest group, those 
which have to do with disconnected memory associations 
alone. Again, when the alcohol is withdrawn there is a 
prompt return towards the normal relative number in 
each group, while a return to alcohol ingestion quickly 
decreases the number in the first group and increases the 
number in the other two. 

A similar result was produced by an attempt to group 
a number of related ideas in series around a central idea 
suggested by a single word, or to describe a chain of 
external events and to name the circumstances relating 
to them in the order of their occurrences. For instance, 
when the subject examined abstained from alcohol the 
word ' 'electricity" suggested a series of ideas like "con- 
tinuous current," "interrupted current/' "alternating cur- 
rent" and the like. On the seventh day, the first upon 
which alcohol was taken (in the same quantity as during 
the preceding experiments), the ability of the mind to 
suggest logically connected ideas decreased, and on the 



FIG. 3. 

NO Alcohol. 40-80 grm. Alcohol per day. No Alcohol. 80.0 grm. Alcohol. 

1-5 day. 6-11 day. 12-17 day. 18-21 day. 22-25 day. 26-27 day. 



too 




" Internal " Associations 

"External" Associations 

Associations not connected in logical thought, • 

(Rhyme, sound, word completion, and unrela- 
ted associations.) 

No. of Associations examined, 1350. 
(Adopted from Dr. A. Smith.) 



ALCOHOL AS A STIMULANT. 65 

17th and 1 8th days, nearly every central word suggested, 
not related ideas or words representing related ideas, but 
groups of words closely connected by a similarity of 
sound, (Unterbau, Baumeister, Meisterstuck, Stuckwerck, 
Werkstatte, Stettenheim). On the 19th day, with a with- 
drawal of the alcohol on the 18th, system in the associa- 
tions returned as in the beginning, and a renewal of the 
alcohol on the 26th and 27th days again brought about 
the disconnected associations. 

Taking those processes which lead to the formation of 
logical conclusions as the highest functions of the brain, 
which they certainly are, while mere word memory or 
sound memory is the lowest, the injurious effects of 
alcohol upon the quality of brain products, upon thought, 
is at once understood. Here is the basis, too, for the pop- 
ular belief that alcohol "stimulates" mental processes 
because it brings about an increased fluency in words. 
It is a practical demonstration of what Kraeplin has 
already quoted, that acute alcohol poisoning makes "more 
words but less thought." 

In the presence of the above definite evidence, but one 
conclusion can be drawn, and that is, the habitual drinker, 
no matter how moderate he may be, in his own estima- 
tion, in the use of alcoholic beverages, never reaches the 
highest possible plane of his physical and mental capabili- 
ties. Very interesting in this connection is a remark made 
by Helmholz, the greatest physicist of the Nineteenth 
Century, in a speech delivered at a celebration of his 
seventieth birthday. He spoke of the ruin of those minds 
which might have originated the most brilliant and original 
thoughts, and closed with the remark that in his own case 
"the smallest quantity of alcoholic drink seemed utterly 
to dissipate them." 



*Cne effects of Hlcobol Upon Digestion and 
Hesimilation. 

The effects of alcohol upon digestion are two-fold: 
first, by irritating the mucous surfaces with which it comes 
in contact; and, secondly, by combining chemically with 
the digestive ferments, the products of digestion, or even 
with the tissues themselves. Added to the disturbances 
resulting from the above mentioned effects are those 
which arise from alcoholic narcosis. 

The irritating effects of alcohol are manifested locally 
in the fauces, pharynx, oesophagus, and stomach, by the 
establishment of a chronic catarrh. The stomach suffers 
the most, for its lining membrane is the longest in con- 
tact with the alcohol. Catarrh produced by alcohol may 
be of all grades of severity from a slight congestion to a 
breaking down of the tissue. Post-mortem examinations 
in a subject dead of alcoholism show the mucous mem- 
brane of the stomach an intense red in color, thickened, 
with patches of infiltrated blood, and other patches cov- 
ered with a tenaceous mucous. Indeed, so great is the 
irritation which may be produced that a suspicion of arsen- 
ical poisoning is often aroused, which is dissipated only 
after a chemical examination. 

Not in the stomach alone, but in other parts of the 
digestive canal there may be intense inflammation. Here 
as in the stomach there is no limit to the inflammatory ac- 
tion of alcohol short of actual disintegration. Intense con- 



EFFECTS UPON DIGESTION AND ASSIMILATION. 67 

gestion first, the outwandering of leucocytes, dilatation of 
the terminal vessels with rupture leading to ecchymoses, 
suppuration and ulceration finally result. In a subject re- 
cently dead of alcoholism, I have seen multiple submucous 
abscesses extending nearly the whole length of the small 
intestine. Mackenzie states (Diseases of the Pharynx, 
Larynx, and Oesophagus, 1880) that the most cases of 
chronic catarrh of the throat come from excessive drink- 
ing of strong alcoholic beverages. Lancereux has seen 
ulceration of the oesophagus and Bergeret stenosis of that 
organ in chronic alcoholism. 

Coincident with the anatomical changes brought about 
by alcoholic irritation are disturbances in the function of 
digestion. There are pain, nausea, vomiting, distress after 
eating, general emaciation and mental depression, the 
degree depending upon the amount of damage which the 
digestive organs have suffered. 

Chemically alcohol interferes with the normal process 
of digestion, by rendering the pepsin inert as long as the 
alcohol is present, and by precipitating the incompletely 
digested albuminoid foods. The amount of chemical dis- 
turbance produced by the imbibition of alcohol depends 
upon the individual, the vigor of his digestive organs and 
his custom in regard to alcoholic indulgence on the one 
hand, and the amount and concentration of the alcoholic 
liquors ingested on the other. Something definite as to 
the nature and degree of chemical disturbances which a 
given amount of alcohol liquor of known concentration 
may produce was worked out by Blumenau in Koschla- 
koff's clinic in 1891 (Wratsch, St. Petersburg). The sub- 
jects of his experiments were five young men from 
twenty-two to twenty-four years of age, some of whom 
were accustomed to the daily use of moderate quantities 
of alcohol and some total abstainers. One hundred cubic 



68 SHALL WE DRINK WINE ? 

centimeters of a twenty-five to fifty per cent solution was 
administered to each from ten to twenty minutes before a 
dinner consisting of five to six hundred grams of soup 
(one pint), a cutlet weighing two and one half to three 
ounces, and 6 to 8 ounces of white bread. 

It will be seen from the above that the quantity of 
alcohol given varied from seven-eighths of an ounce to one 
and three-quarters ounces and that it must have been 
markedly diluted after reaching the stomach for not much 
of a pint of soup under ordinary circumstances would 
be absorbed in ten to twenty minutes. Assuming that 
only ten ounces of fluid remained in the stomach, the 
alcohol solution would have a strength of only four to 
eight per cent. 

The effects of this quantity of alcohol thus administered 
were as follows: For three hours after the alcohol was 
ingested there was a very noticeable decrease in digestive 
activity; the general activity of the gastric juice decreased, 
lactic acid being practically the only acid present, while 
hydrochloric acid was almost wholly absent; from four 
to six hours after the alcohol was taken, digestion became 
more energetic, the general activity of the juice rose about 
50% above the normal (from 0.22 to 0.35%), the propor- 
tion of hydrochloric acid also increased to beyond the 
normal (.12% to .14%), while, at the same time, lactic 
acid decreased and finally ceased to be present in sufficient 
quantity to give any reaction. 

With the increase in acidity the gastric juice acquired 
an increased digestive power and under alcohol irritation 
the secretion of the juice was more profuse and lasted for 
a longer time than in its absence. During the first hours 
following the alcohol ingestion the amount of pepsin was 
also noticeably decreased as could be demonstrated by 
artificial digestion tests. 



EFFECTS UPON DIGESTION AND ASSIMILATION. 69 

All the changes above described were more pro- 
nounced in subjects not accustomed to alcoholic beverages, 
and strong solutions of alcohol produced more intense 
changes than weak ones. 

It would seem, from these results, alcohol first paralyzes 
the peripheral nerve endings in the stomach mucous mem- 
brane as it does elsewhere, thereby rendering the cells 
supplied by them capable of secreting neither the normal 
amount nor kind of gastric juice. After the paralyzing 
effects have passed away, however, there still remains the 
irritating effects of the alcohol, and a more than normally 
energetic secretion of gastric juice takes place. Un- 
doubtedly the presence of a strong alcoholic liquor in the 
stomach will retard digestion both by its effects upon 
pepsin and upon the partly digested albuminoids, pre- 
cipitating the latter, which must be redissolved before 
digestion can again go on. These effects are, however, 
of secondary importance to the effects upon the nerve 
filaments. Significant, too, is the fact that the retardation 
was greater in the case of those unused to alcoholic liquor. 
If it were due solely to chemical causes there should be 
no difference between the abstinent and those accustomed 
to alcohol. Furthermore, the activity of the epithelial cells 
of the stomach was shown to be decreased in Blumenau's 
experiments from the fact that absorption was also lessened 
by the ingestion of alcohol. 

The movements of the muscular wall of the stomach 
were also seen to be decreased in the experiments of 
Blumenau, which might have been anticipated, as those 
movements are probably the result of reflex stimulation of 
the gastric membrane. 

Mohilanski (Medical Chronicle Nov., 1889) found that 
in those habituated to a moderate amount of alcohol daily, 
less food was assimilated during the days of abstinence 



70 SHALL WE DRINK WINE? 

than during the days upon which alcoholic liquor was 
ingested. In some cases the difference amounted to as 
much as 4.22% but averaged only 2.09%. With the 
habitual abstainer, on the other hand, the powers of 
assimilation invariably decreased with the ingestion of 
alcohol when given in quantity of two to five ounces of 
absolute alcohol in divided doses during the twenty-four 
hours. 

Mohilanski attributed the increased assimilative power 
of the stomach after alcoholic ingestion in the habitue class 
to "an intensified gastric juice which resulted from pro- 
longed retention of food in the stomach on the one hand 
and from increased digestive power and secretion of gastric 
juice on the other." A more probable explanation, how- 
ever, is that in the habitue class, alcohol, or its irritating 
or narcotic qualities, from long continued use, becomes a 
necessity for assimilation as is the case with opium and 
other narcotics. It is impossible to see why it should 
not otherwise have the same effects with both the abstinent 
and habitue classes. He also found that nitrogenous 
metabolism always decreases. In thirteen of the fifteen 
persons subjected to experiment there was an average fall 
of 8.73%, the maximum being 19.42% and the minimum 
0.14%. This decrease was observable when small doses 
were taken and was invariable with moderate quantities. 
No strict parallelism existed, however, between the 
amount of alcohol ingested and the amount of metabolic 
decrease. The decrease continued some days after the 
alcohol was discontinued. The decrease in tissue metabol- 
ism was attributed by Mohilanski to the action of alcohol 
inhibiting systemic oxidation, changing the blood pressure, 
dilating the vessels retarding the circulation, and thus de- 
pressing bodily temperature. 

All investigators who have studied the subject agree 



EFFECTS UPON DIGESTION AND ASSIMILATION. 71 

that alcohol interferes with the oxidation of fatty foods, 
much more fat being excreted unchanged after alcohol 
ingestion than during abstinence. As we have already- 
seen alcohol makes such a demand upon the respiration 
and tissues for oxygen that the normal oxidation in 
all parts of the system is disturbed. 

It will be noted that the experiments of Mohilanski 
by showing that alcohol, in decreasing the output of 
products resulting from proteid metabolism, seems to act 
as a conservator of the tissues; and thus warrant a con- 
clusion opposite to that drawn by Miura. This, however, 
is not necessarily so. There are two sources from whence 
the products of tissue metabolism are derived, the food 
ingested and the tissues themselves. Anything which 
would interfere with the oxidation of the nitrogenous food, 
so that it would in part or wholly leave the intestinal canal 
unchanged, would necessarily decrease the output of pro- 
teid metabolism, while at the same time the various tissues 
of the body might suffer as much or more than they would 
during complete abstinence from alcohol. Practical ex- 
perience has certainly demonstrated that alcohol alone in 
no quantity, either large or small, has the power of con- 
tributing to bodily weight in the shape of subcutaneous fat. 

According to Wilkins (New York Medical Journal, 
Sept. 22, 1894,) alcohol precipitates ptyalin, forming with 
it an insoluble combination of the small amount of 
albuminous matter present. It also neutralizes the fer- 
mentative power of ptyalin, thus interfering with its physi- 
ological functions. In the small intestine alcohol especially 
interferes with the digestion of fats. It does this by 
coagulating the pancreatic juice, rendering it incapable of 
emulsifying the fats. This is one of the fruitful causes of 
fatty degeneration of various organs. The stearin of the 
fat is dissolved out of the fat globules, being aided by the 



72 SHALL WE DRINK WINE? 

duodenal secretions. The remainder of the fat thus be- 
comes a foreign body in the circulation, and being a com- 
pound ol palmatin .md olein only, does not possess that 
property by virtue of which it is attracted to the adipose 
vesicle ; but is deposited in the different organs, even in the 
ventricles of the heart and great vessels, thus constituting 
degeneration. 

The glycogenic function of the liver is modified by 
the excessive use of alcohol, by preventing the rehydration 
of the alcohol, without its being taken up by the capil- 
laries and put into circulation. This result is accomplished 
by the union of alcohol with water, which cannot be used 
in any physiological process, the mixture of alcohol pro- 
ducing a pathological result instead of a physiological one. 
The oxygen of the blood and water is prevented from 
uniting with the bilirubin to form biliverdin. Physiologic- 
ally, therefore, even a small quantity of alcohol is inimical 
to life. 

Before leaving this subject attention should be called 
to the fact that in habitual drinkers the vegetative and per- 
haps all other functions are stimulated by the presence 
of alcohol. Putting it in another way, and this seems the 
correct way to express it, with the habitual drinker, the 
absence of alcohol is attended by a decreased activity in 
all the physiological functions. This is simply analogous 
to what is seen in the habitue of any form of narcotic. In 
one accustomed to taking a considerable daily quantity of 
opium, its sudden withdrawal is attended by disturbances 
of every physiological function, sometimes of a gravity 
dangerous to life. The patient can eat nothing, digest 
nothing, may indeed be on a condition of physical and 
mental collapse. A dose of his accustomed narcotic 
promptly brings about a re-establishment of the, to him, 
normal order of things. He eats, digests, walks about, 



EFFECTS UPON DIGESTION AND ASSIMILATION. 73 

and talks naturally and cheerfully. Not that the physiol- 
ogical functions can ever be carried out to the highest 
point of efficiency under the influence of any narcotic; but 
the narcotic habitue establishes for himself a grade of 
physiological efficiency, the key-stone of which is the nar- 
cotic, which, if it be suddenly taken away, allows the whole 
artificial physiological structure to tumble to the ground. 
After a time nature readjusts the organism to the absence 
of the narcotic; but until that readjustment is accom- 
plished the habitue will show less energy in all his func- 
tions than during the period of his narcotic ingestion. 

The amount of disturbance following the withdrawal 
of an accustomed narcotic is, other things being equal, in 
direct ratio with the amount daily consumed. 

One accustomed to the narcotizing effects of a few 
ounces of alcohol daily would undoubtedly exhibit a de- 
creased assimilative power after its withdrawal. In fact 
just such results as those obtained by Mohilanski ought 
to be expected. 



VL 
General pathology of Hlcobolism. 

The key-note of alcohol morbidity is decreased tissue 
resistance, brought about by alcohol ingestion. The bio- 
chemistry of alcoholic tissue degradation is not fully under- 
stood; but it is probably based upon lack of oxidation and 
other nutritive disturbances. Of disturbances in tissue 
oxidation by alcohol, which has been so luminously ex- 
plained by Dr. A. Smith, much has been written; Prout, 
Edward Smith, Harley, Schmeideberg, Vierordt, and other 
well known writers having contributed much valuable 
information upon the subject. More recently J. J. Ridge 
(Medical Pioneer, Endneld, Eng., 1894,) has discussed the 
subject in relation to haemaglobin as a carrier of oxygen 
to the tissues and carbon dioxid away from them. He 
has shown that under the influence of alcohol the time 
necessary for the absorption of oxygen by haemoglobin, 
as well as the time necessary for it to part with its carbon 
dioxid, is markedly lengthened. Undoubtedly this dis- 
turbance results, in part at least, from the affinity of 
alcohol for oxygen; but the irritating and narcotic prop- 
erties of the poison may have some influence upon the 
cell life of the corpuscle, directly. Similarly, in all struc- 
tures of the organism, it is not unlikely that irritation and 
narcosis play an important role in decreasing resistance, 
aside from that caused by the interference with oxidation. 

Upon this same subject, Gaule of Zurich (Bulletin 
Medical, Paris, Aug. 25, 1895,) alluded to the fact that 



GENERAL PATHOLOGY OF ALCOHOLISM. 75 

experiments upon elementary organisms had shown that 
alcohol causes atrophy by removing the water contained 
in them, and that the experiments performed in his labora- 
tory, by Obersohn, show that alcohol has the same destruc- 
tive influence upon cell protoplasm as is seen in ether 
and chloroform. 

The decrease of tissue resistance resulting from alco- 
holic poisoning has been the subject of much investiga- 
tion in very recent times, and the information thus obtained 
is of the utmost interest and importance as explaining 
the increased severity of bacterial diseases when the sub- 
ject is a victim of alcoholism. In a series of experiments 
conducted by A. C. Abbott (Jour. Exper. Med. July, 1894), 
under the auspices of the "Committee of Fifty," he found 
that the normal tissue resistance of rabbits against the 
streptococcus of erysipelas is markedly decreased when 
the animal has been kept under the influence of alcohol, 
sufficient to intoxicate slightly, daily for several weeks. A 
similar, but not so conspicuous, diminution of resisting 
powers was exhibited against the colon baccillus (bacillus 
coli communis) under the same conditions. Against the 
bacterium of pus (staphylococcus pyogenes aureus), there 
were individual cases showing a decreased resistance when 
the alcoholized animals were inoculated in various ways. 
Still it,could not be said that there was a marked difference 
in this respect between the alcoholized and the non- 
alcoholized animals, as far as this particular bacterium is 
concerned. It is particularly interesting and instructive 
to learn that the results of inoculating the alcoholized 
rabbits with the germ of erysipelas bore a striking resem- 
blance to the course of the disease observed in the alcohol- 
ized human subject. The effects of the erysipelas inocula- 
tions were not only manifested earlier in the alcoholized 
animals; but the disease ran a much more violent course, 



76 SHALL WE DRINK WINE ? 

the abscesses being much deeper and more destructive. 
Abbott looked for structural changes which might explain 
the lack of normal tissue resistance, but found nothing in 
the way of macroscopic change which would throw any- 
light on the subject. He believes that a closer examination 
might show some abnormality of structure brought about 
by the alcohol to which the cell owes its diminished power 
to resist bacterial invasion. 

Such evidence as we have, however, indicates that the 
change is chemical rather than physical, as is the case in 
immunity. 

Not only is the vital resistance markedly decreased by 
alcoholic poisoning; but the intestinal congestion thereby 
produced favors the outwandering of bacteria found nor- 
mally in the intestinal canal. An inquiry into this subject 
was made by Wurtz and Hudelo (Bulletin Medical, Paris, 
Jan. 30, 1895), who found that intestinal bacteria are driven 
out during alcoholic coma. Rabbits were intoxicated 
with ethyl alcohol and killed when a profound state of 
narcosis was reached. In one-half of the rabbits killed 
micro-organisms were found in the peritoneum and blood 
of the portal vein, showing that microbes during alcohol 
congestion pass through the walls of the intestine and 
veins, as is the case in certain other poisons, cold, and 
asphyxia. They believe, therefore, that this diffusion of 
microbes plays a part in the production of peritonistis and 
liver troubles of alcoholism. 

Very instructive in this respect is the establishment 
of an increased vulnerability to the cholera bacillus in sub- 
jects accustomed to alcoholic indulgence. During the epi- 
demic of 1848 and 1849 Professor Adams of Glasgow esti- 
mated that 19.2 per cent, of the abstinent class died with the 
disease, while of the drinking class 91.2 per cent, of all 
attacked by the plague succumbed. He would, therefore, 



GENERAL PATHOLOGY OF ALCOHOLISM. 77 

put over the door of every dram shop, "Cholera for sale 
here." During the epidemic it was further observed that 
most of the new cases of illness occurred immediately 
after a Sunday or holiday, which was generally spent in 
drinking. 

Of the highest interest, in judging the worth of Dr. 
Adams' conclusions, is the result of an investigation made 
by Dr. Thomas in the Strasburg Clinic, as to the predis- 
posing role of alcohol in cholera infection (Archiv. f. 
experim. Path, und Pharm., Bd. XXXII., Heft i). He 
showed that alcohol increased the predisposition to cholera 
sixfold in rabbits, a result which closely corresponded 
with the observations of Adams on the human subject. 
Nor was this predisposition due to the gastro-intestinal 
catarrh inaugurated by the alcohol. A far greater degree 
of irritation was produced by such substances as Croton 
oil and cantharides, in other animals, without in any way 
increasing the predisposition to cholera. Moreover, alco- 
hol did not lose its predisposing influence, even when 
solutions were used too diluted to produce any irritation 
of the stomach or bowels whatsoever. From these experi- 
ments it was decided that alcohol diminishes the bac- 
tericidal properties of blood serum, and that a small 
quantity of alcohol is effective for this purpose. 

When the last cholera epidemic prevailed in Germany, 
the government sanitary officials advised the drinking of 
alcoholic liquors as a preventive measure. This advice 
was based upon the fact that the comma bacillus has not 
yet been found in concentrated alcoholic solutions. But, 
as Dr. Smith says, the comma bacillus has not yet been 
found in concentrated sulphuric acid, nitric acid, 
hydrochloric acid, nor strong solutions of copper sulphate 
any more than in rum and cognac, which articles might 
for just the same reason be recommended as preventives 
of Asiatic cholera. 



78 SHALL WE DRINK WINE? 

In no direction is the tissue debasement of alcoholism 
more noticeable than in tuberculosis. The frequent 
occurrence of tuberculosis in alcoholics was long ago a 
matter of record. It was spoken of by physicians of the 
last century and has been confirmed beyond doubt by 
numerous observers during the past twenty-five years. 
Lancereaux (Le Bulletin Medical, March 6, 1895,) declares 
that he has held this opinion for more than thirty years. 
He could, he says, produce many proofs to support it. 
The phthisis of drunkards is peculiar. Instead of first 
involving the front of the left apex, which is the classical 
site for its commencement, when it results from insufficient 
aeration or nutrition it attacks the right apex posteriarly, 
producing lessening of elasticity on percussion. It is also 
different in its evolution, for the disease generally improves 
after the first attack, and the patient frequently recovers, 
if he give up his bad habits and properly nourish himself, 
even though the disease may have been attended by 
hemorrhages. This, however, he rarely does. A second 
and a third attack follows, converting the first attack into 
an alarming condition due to the dissemination of the 
tubercles. In some cases this dissemination is general 
from the beginning; but, even in these cases treatment 
may meet with success and the process be arrested. In 
other drunkards tuberculosis simultaneously affects the 
lungs, meninges of the brain and the peritoneum, quickly 
causing death. This phenomenon he has often seen in 
market-porters, coopers, and truckmen. In all cases, he 
believes, alcohols and essential oils, by diminishing organic 
combustion and being eliminated by the lungs, create at 
the same time a general and local predisposition which 
furnishes a proper field for the growth of tubercle bacilli. 

Lancereaux further contributed (Bulletin Medical, June 
26, 1895,) valuable evidence in support of these views by 



GENERAL PATHOLOGY OF ALCOHOLISM. 79 

showing that the increase in tuberculosis is in proportion 
to the increase in alcoholic consumption. Alcoholism did 
not become notable in France until after the vines had 
been destroyed by the phylloxera. At that time pul- 
monary consumption was met with in men only one half 
as often as in women. At the present time twice as 
many men as women are afflicted, because the women of 
France, as a rule, are not habituated to the use of excessive 
quantities of alcohol. 

Legrain also (Medical Press & Circular, London, Jan. 
13, 1894,) speaks of having observed 55 cases of tuber- 
culosis in 819 descendants of 215 cases of alcoholic 
parentage. 

T. D. Crothers (Journal of Am. Med. Assn. Apr. 9, 
1898,) takes the ground that alcoholic inebriety and 
tuberculosis are allied diseases. He says that in some 
families the two conditions alternate. Some of the 
members drink to great excess, then abstain, contract 
tuberculosis, and die. Others have all the signs of con- 
sumption when they begin to drink and recover it, but 
become inebriates afterward, and die suddenly of acute 
pneumonia or nephritis. Instances of the former class 
are very common, and in these the course of the disease 
is very rapid. In the case of the latter class alcohol seems 
to abort the tuberculosis in some cases while in others it 
makes the progress of the disease more rapid. 

In his experience with 2,000 cases fully twenty per cent, 
were associated with tuberculosis; but a much larger per- 
centage of all cases of alcoholic inebriety die from tuber- 
culosis, "of which, probably, there was no intimation until 
the end of life." Close observers know that these cases 
have a heredity and a great variety of symptoms in com- 
mon. The phthisical insanities mentioned by Dr. 
Maudsley, inherit qualities which lead first to inebriety and 



80 SHALL WE DRINK WINE? 

later to the development of tuberculosis. Insanity some- 
times develops in these cases; but is not so frequent as 
tuberculosis ; and, when it does occur, it is usually traceable 
to some injury like sunstroke or mental strain. Physical 
and mental unrest due to inherited degeneracy drive the 
victim to the narcotic effects of alcohol for relief; but 
inebriety, producing a still greater degree of degeneracy, 
prepares the subject for tuberculosis provided degeneracy 
has not taken on acute forms in other centres leading to 
inflammation. 

The production of bronchial catarrhs by alcoholic 
drinking lead in the same way to the invasion of tuber- 
culosis. Dr. Sharkey in The Journal of the London 
Pathological Society is quoted as saying that disturbances 
and lesions of the vagus were such as may come from 
alcoholism, by lowering the nutrition of the lung, and pre- 
pare it to become the nidus of the tubercle bacillus. Ref- 
erence is also made to the exhaustive paper of Dr. Alison 
(in Archives Generales de Medicine) relative to tuber- 
culosis in alcoholics. In the study of eighteen hundred 
cases he reached the positive conclusion that alcohol pre- 
disposed subjects to tuberculosis both by producing a local 
irritation and lowering the general vitality. He believes 
that inebriety and tuberculosis are interchangeable, both 
following from the same general cause and producing 
death by the latter before the age of forty. After that age 
acute inflammations are more common. 

Reference is also made to the writings of Dr. Mays 
in the Journal of Inebriety for 1889, Dr. Irwell, in "Race 
Deterioration," Dr. Williams in his work on Pulmonary 
Consumption, Dr. Clouston of Edinborough and Dr. 
Payne in "Pathology of Chronic Alcoholism." The 
evidence given by these writers is corroborative. In all 
of them the relation of alcoholism and tuberculosis is con- 



GENERAL PATHOLOGY OF ALCOHOLISM. 81 

firmed by numerous observations, and the part played by 
heredity in producing alcoholic inebriates from phthisical 
parents and consumptives from alcoholic parents is 
referred to at length. 

To these I could add numerous cases in my own experi- 
ence, two of them occurring within the past few months. 
The first was a nervous, erratic man of 36 years of age, 
possessing a restless energy and given to frequent out- 
bursts of passionate rage. His heredity was bad, his 
father having been an alcoholic, and several brothers and 
sisters died in infancy. He had been addicted to the use 
of large quantities of alcoholic liquors, chiefly in the form 
of strong spirits, but married and gave up alcohol entirely. 
About this time he had a bronchial catarrh but no evidence 
of tuberculosis. Soon, however, the characteristic symp- 
toms developed and he died in a few months of pulmonary 
consumption. 

The other was a young man of 32. He had been a 
hard drinker for ten years or more ; but finally "graduated" 
from a local institution for drunkards and became a total 
abstainer. His health was only fair after this and began 
to fail in a few months, chiefly because of digestive dis- 
turbances. This was in September. In January following 
there was complete infiltration of the right lung, with 
cavities of the apex. An attack of pneumonia supervened 
in February, and the already rapid course of the disease 
was made still more rapid, death occurring on the first of 
March. What the hereditary influences in this case were, 
as regards alcohol, I do not know, but there was no history 
of tuberculosis. 

Several other similar cases occur to me as I write these. 
In some of them there was a history of heredity alcoholism 
or consumption or both, while in others pulmonary con- 
sumption cut short a life the greater part of which had 



82 SHALL WE DRINK WINE? 

been spent in alcoholic dissipation. None of these cases, 
however, as I recall them, present any special features not 
already mentioned. They would be simply in the nature 
of corroborative testimony. 



VIL 
Hkoboltc fieart Diseases, 

In the healthy subject death results from failure of 
respiration, when a lethal dose of alcohol is taken, through 
narcosis of the respiratory center of the medulla. Death 
may result, however, from heart exhaustion due, no doubt, 
to the irritating effects of alcohol, when large doses are 
ingested at short intervals, but not sufficient in quantity to 
produce profound narcosis. This form of alcohol poison- 
ing is often seen in subjects who tolerate enormous quan- 
tities of alcohol without being sufficiently narcotized 
thereby to produce prolonged sleep, death usually occur- 
ring at the end of a prolonged spree attended by evidence 
of great nervous excitement. 

There is no doubt that alcohol acts directly upon the 
heart to produce its irritating effects, and there is good 
reason for believing that when death results from heart 
failure due to alcohol it is brought about by the direct 
poisoning of the heart muscle or its ganglia. I have seen 
five cases resulting fatally in which no organic change in 
the heart could be made out during life; and, in two of 
these, post-mortem examinations showed no changes in 
the heart muscle sufficient to account for the fatal termina- 
tion. Yet, in all of these, death was sudden and followed 
a debauch in which great quantities of alcohol were drunk. 
Two of these cases, the two upon whom post-mortems were 
held, are so instructive and seem to so fully confirm the 
belief that death may result from sheer heart exhaustion 



84 SHALL WE DRINK WINE? 

due to the long continued irritant action of alcohol that 
I shall quote them in full: 

M. J., a man 43 years of age, large, muscular, well 
nourished, and had never had any serious illness. His 
social status was good and he held a municipal office of 
considerable importance. He consulted me in the latter 
part of November, just after or during a debauch of two 
or three weeks, during which time he drank large quan- 
tities of strong liquor. At this time his most marked 
symptom was a very rapid and feeble pulse, so rapid that 
it was almost impossible to count it and so feeble that the 
entire surface of his body was cyanotic. Upon careful 
examination, no organic change in any of the chest organs 
could be made out; but there was a moderate amount of 
albumen in the urine. He did not make a rapid recovery; 
but about the first of the following March his heart was 
apparently normal in all respects, albumen disappeared, 
and he declared he felt as well as he ever did. During 
the last days of the following May he again began to 
drink excessively, and continued his excesses for nearly 
two weeks. I saw him again at this time and he pre- 
sented a condition identical with that of the preceding 
autumn. A day or two afterwards, while attempting to 
sit in a chair, he fell over and expired suddenly. 

Post-mortem examination disclosed the usual irrita- 
tion due to drunkenness but not in a marked degree; for, 
at the time of his death, he had had no alcohol for three 
days. The heart was not dilated. It had, however, a 
sodden intensely red appearance and a few pigmented 
points due to the deposition of broken down blood 
corpuscles. 

The second case, W. G. G., male, 29 years old, a 
traveling salesman in easy financial circumstances. He 
drank periodically, going on a spree for from one to three 



ALCOHOLIC HEART DISEASES. 85 

weeks, and then totally abstaining for six months or more. 
Twice I treated him for the disorders following acute alco- 
holism, mostly disorders of the nervous system, once for 
incipient delirium tremens. About six months preceding 
the attack which terminated fatally, and about one month 
after a characteristic excess, he complained of some heart 
disturbance. An examination, however, disclosed no or- 
ganic trouble, but the pulse was rapid, 90 to 100, and fee- 
ble. According to instructions, he returned twice more for 
examination and advice. A noticeable improvement upon 
his second visit was followed by a complete return to 
the normal state upon his third visit. The debauch which 
ended in his death was like many that had preceded it 
excepting that it had not continued so long, being volun- 
tarily cut short by the patient himself because of extreme 
palpitation of the heart. For four or five days after the 
withdrawal of the alcohol he ate but little, was weak and 
cyanosed, and had a feeble pulse running from 98 to 130 
per minute. About eleven o'clock on the morning of the 
sixth day of abstinence, while sitting on the edge of his 
bed in the act of putting on his shoes he fell over, and 
expired in a few moments. 

Post-mortem examination was held twenty-four hours 
after death. There was some irritation of the mucous 
membrane of the intestinal tract with a few petechial spots 
near the cardiac end of the stomach. The heart showed 
no organic change beyond what might be considered a 
lack of normal firmness of its muscle. An examination of 
the brain was not permitted. 

Of the three other cases in which death could appar- 
ently be traced to direct exhaustion of the heart by the 
irritant action of alcohol, one was a periodic drinker who 
died suddenly forty-eight hours after the ingestion of the 
last alcohol, one was a chronic alcoholic who died soon 



86 SHALL WE DRINK WINE ? 

after an attack of excessive palpitation without organic 
trouble that could be detected by examination, and the 
third, a moderate drinker with periodical excess, died on 
the first day of an attack of pneumonia, presumably of 
heart exhaustion. Of this group the first two were under 
forty and the last one 52 years of age. 

Undoubtedly the usual cause of death from heart dis- 
ease in subjects of chronic alcoholism is some organic 
change produced by the long continued action of the poi- 
son. Fatty degeneration and dilatation with consequent 
valvular insufficiency probably are the usual changes; but, 
in the absence of any of these, direct heart exhaustion must 
be regarded as the cause of a fatal issue. The lack of 
nutrition is also an important element in contributing to 
this species of heart failure. Drunkards, especially peri- 
odic drunkards, in their excesses rarely take even a mod- 
erate amount of nourishment. Sometimes they will go 
for days or a week practically without food. With some, 
too, alcohol produces a species of mania, during which 
very little sleep is taken. This lack of food, lack of rest, 
and all the destructive disturbances incident to the inges- 
tion of large quantities of alcohol must contribute pow- 
erfully to the fatal issue of heart exhaustion of alcoholism. 
Parkes and Wollowicz, in their classical work on alco- 
hol, called attention to the fact that four ounces of alcohol 
ingested in the course of twenty-four hours causes an ad- 
ditional labor, on the part of the heart, of 12,960 pulsations; 
and they express the opinion that so much additional labor 
on the part of the heart, amounting to about one-eighth 
of the normal work, must speedily lead to exhaustion 
of that organ. This view, however, is untenable. 
Mere stimulation of the heart leads to hypertrophy of the 
muscle which may be compensatory as when the circula- 
tion is obstructed, or necessary to meet the requirements 



ALCOHOLIC HEART DISEASES. 87 

of severe physical labor. In either case the hypertrophy 
is not pathological but necessary for a new order of things. 
In other words the heart exhaustion of alcoholism is not 
the result of an increased amount of work which it is called 
upon to perform; but to the degenerative changes in the 
heart muscle, nerves or ganglia brought about by the direct 
poisonous effects of the alcohol. Hypertrophy of the 
heart in chronic alcoholism is frequently observed; but it 
may have arisen from co-existent cirrhosis of the liver 
and kidneys. Another cause of drunkards cardiac hyper- 
trophy, to which not much attention has been given, results 
from the increased labor the heart is called upon to per- 
form by reason of the enormous quantity of water which 
is introduced into the circulation of wine and, especially, 
beer drinkers. The water in two or three quarts of wine 
in addition to the usual fluids drunk at meal times must 
add to the intra-vascular pressure in a marked degree. 
In beer drunkards, who consume from two to sixteen 
quarts of beer every twenty-four hours, the labor of the 
heart in ridding the distended circulatory system of this 
enormous surplus of fluid, must be sufficient to lead to 
hypertrophy, or in cases in which the hypertrophy is insuf- 
ficient to meet the increased demands made upon the 
heart, dilatation must result. As a matter of fact, enlarge- 
ment of the heart is very common, according to Struem- 
pell, in Bayreuth, Munich, and other beer cities of Ger- 
many, an observation confirmed by other German phy- 
sicians. 

But the increased amount of fluid within the circulatory 
organs is not alone sufficient to produce the changes seen 
in the hearts of beer drinkers. The excess of carbohy- 
drate food material which a beer drinker takes into his 
circulation with five or ten quarts of beer cannot be 
appropriated, but remains in the circulation, increasing 



88 SHALL WE DRINK WINE? 

the specific gravity of the blood, thus adding another fac- 
tor to the hindrance of circulation. The increased sup- 
ply of carbohydrate food aids, moreover, in the production 
of fatty degeneration which, as we have seen, results 
from alcohol interfering with the normal evolution of fat 
digestion and assimilation. 



VIIL 
Hlcoboltc Irritation of Other Organs* 

If we do not lose sight of the fact that alcohol is an irri- 
tant and as such gives rise to conditions identical with 
those attending an ordinary inflammation, we shall find 
it easy to understand the destructive changes produced 
in the various tissues by long contact with alcohol. 
Wherever it comes it produces a dilatation of the blood 
vessels and an outwandering of the leucocytes. These 
are finally organized into connective tissue to take the 
place of the more highly organized tissue which it dis- 
places, or, by contraction, deprives the normal tissue of 
its proper supply of blood, thereby causing it to atrophy. 

In the kidney alcoholic irritation is manifested by an 
increase in the elements of its cortical substance at first, 
followed by contraction and decrease in the bulk of the 
entire organ. The uriniferous tubes are destroyed partly 
by this subsequent contraction, but chiefly by the direct 
action of alcohol upon the epithelial cells themselves. 
The longer the poisonous influence of the alcohol is 
exerted over the organ, the more likely will be the kidney 
to exhibit cortical change; but the greater the quantity 
of alcohol consumed, other things being equal, the more 
the epithelium is likely to suffer. Another form of alcoholic 
nephritis has been pointed out by Strumpell, the so-called 
acute nephritis of alcoholism, in which there is a sudden 
breaking down of great areas of epithelium. This seems 
to result from a cumulative effect of chronic alcoholic 
intoxication. 

89 



90 SHALL WE DRINK WINE? 

In the liver and probably in the spleen and pancreas, 
although not much attention seems to have been given 
these latter organs in alcoholism, there is an increase in 
connective tissue of the cortical substance with a destruc- 
tion of the epithelial cells. In the liver the interlobular 
connective tissue contract, giving rise to prominences 
on its surface, characteristic of alcoholic inflammation, 
a condition known as "hob-nail" liver. 



IX. 
'Che effects of Hlcobol on the Nerve Oesue. 

Of all tissues of the body those which enter into the 
structure of the nervous system are the most profoundly 
affected by alcohol. Here, as elsewhere, alcoholic degen- 
eration is characterized by two classes of changes: A 
destruction of cell protoplasm and an increase in con- 
nective tissue elements; but, as has been shown by Gaule 
of Zurich, those cells which are the most highly differ- 
entiated, which are called upon to perform the most com- 
plex functions, suffer the most and are the earliest to be 
affected, brain and other nerve cells are more profoundly 
injured than those of any other part of the body. 

This destruction of the cell protoplasm is shown in 
the shrunken, flattened convolutions of the brain of an 
alcoholic subject, and a microscopic examination discloses 
an atrophy not only of the cells but also of the nerve 
fibers. There is a great proportional increase in con- 
nective tissue, and a part of the cell atrophy may be due 
to consequent pressure by the connective tissue upon 
the cells. According to Bevan Lewis (Text-book of Men- 
tal Diseases, 1889,) the vessels which pass into the brain 
cortex are enlarged, and their coats in an advanced state 
of inflammatory and fatty change. There is a prolifer- 
ation of the adventitious sheath nuclei, the protoplasm 
of which is undergoing fatty degeneration. A great 
number of scavenger cells pervades the external region 
of the peripheral zone of the cortex lying immediately 



92 SHALL WE DRINK WINE? 

behind the pia, "their branching processes forming a 
dense matting which converts the outermost fourth into 
a closely netted substance of minute meshes." These 
scavenger cells are in greatest number where the vessels 
pass downward through the cortical layers, resembling 
the connective tissue increase along Glisson's capsule in 
alcoholic inflammation of the liver. The deepest layer 
of cells in the brain cortex are the most affected, the 
upper, beyond the fifth, are sometimes apparently not 
invaded. The motor area is that chiefly involved. In 
the lowest layer, the spindle-cell formation, the scavenger 
cells are sometimes so great in number as to conceal the 
spindle-cells from view, the nerve elements being preyed 
upon by the scavengers. In the spinal cord there are 
similar changes, but particularly in the walls of the blood 
vessels, some of the smallest vessels being entirely oc- 
cluded by the increase in their muscular walls. 

In recent years much has been done in working out 
the characteristic nerve changes of acute and chronic 
alcoholism. The researches of Jackimoff (Bulletin of An- 
thropology, Paris, 1890,) showed in puppies and dogs 
which had for a long time been fed on diluted alcohol, 
characteristic changes. In animals which died of intox- 
ication the brain was congested and infiltrated with new 
connective tissue cells. The cells of the grey matter of 
the spinal cord, especially of the anterior cornua, showed 
intense disintegration, exhibiting many vacuoles, gran- 
ules and indistinct nuclei. These changes were found also 
in the medulla oblongata but in a less degree. 

Berkley in a paper entitled "The Action of Ethyl Al- 
cohol on the Cortical Nerve Cells" (American Journal of 
Insanity, July, 1895, and the Glasgow Medical Journal, 
Dec, 1895,) records the results of the examination of five 
rabbits which had been fed with dilute alcohol for periods 



THE EFFECTS OF ALCOHOL ON NERVE TISSUE. 93 

varying from six months to a year, and which had nearly 
all died in convulsions. In the vascular wall there were 
only slight changes, principally a slight increase in the 
nuclei of the intermediary vessels, some thickening of the 
walls, some crystals of haematoidin in the surrounding 
lymph spaces, with a definite dilatation of the lymph 
spaces surrounding the blood channels and an occasional 
small hemorrhage due to rupture of a blood vessel. The 
greatest changes were found in the nucleoli. They were 
much enlarged, roughened, and spongy with elongated 
projections from the surface. A large number of the 
pyramidal cells had tumefactions of varying size on their 
protoplasmic branches or dendrons. These tumefactions 
commenced, apparently, on the outer end of the dendron 
and were accompanied by a disappearance of the latter 
buds of the dendritic processes. In the cells of Purk- 
injie of the cerebellum the same alterations but more pro- 
nounced were observed. The structure of the axis cyl- 
inders was normal. The structures of the neuroglia were 
also invaded. 

From the fact that the arterial changes observed were 
so insignificant, Dr. Berkley thinks that the changes pro- 
duced could not be the result of lack of nutrition, but 
must be charged to the direct irritative action of the alco- 
hol on the cell protoplasm. 

The observations of JackimorT and Berkley are con- 
firmed by other investigations. Recently Hoch (Amer- 
ican Journal of Insanity, Vol. LIV., P. 600 et seq.) re- 
ported the cell changes in a man recently dead of delirium 
tremens. These changes he found were uniform. The 
cell substance which ordinarily takes the stain for obser- 
vation is lost and that which ordinarily is not suscepti- 
ble to staining takes the coloring matter instead. The 
cells have a mottled appearance. The nuclear wall is 



94 SHALL WE DRINK WINE ? 

uncommonly distinct and the nucleus contains numerous 
sharp granules which are often seen distributed in the 
net-work. The nucleolus is not enlarged but may show 
light areas. The next change, a greater disturbance or 
destruction of the cell, shows the nucleus lighter, the 
nucleus wall less distinct and more irregular in its outline, 
the nuclear net-work loses its sharpness and the nucleolus 
becomes paler and in some instances distinctly smaller. 
In the last stage the nucleus becomes very pale, either 
small or very large, often very ragged in its outlines, the 
nuclear membrane being indicated only by dots, the con- 
tents being indistinct and speckled with numerous gran- 
ules. The nucleolus is either of normal size or very small, 
very pale, or it may be entirely absent, this being the 
most common occurrence. These changes are most prom- 
inent in the deepest layer (the fifth) and least pronounced 
in the second layer of cells. The dendritic processes far 
away from the cell assume a crumbled appearance. 

In the neuroglia there are large white spaces around 
the nuclei, the cell body is visible in parts, often having 
granules in it, the pigment is often well seen, the chromatin 
is present in coarser granules than normal, and there is 
an increase in the neuroglia nuclei. Besides we have in 
the first layer well marked spider cells. 

The vessels frequently present no abnormality, some 
stand out prominently, partly on account of the neuroglia 
nuclei of the surrounding tissue. The vessel walls are un- 
altered. 

What chemical changes are undergone during the 
process of cell degeneration is not known. There can be 
no doubt, however, that they are as important as the 
structural changes would seem to indicate. 

Commensurate with the physical changes shown by 
the microscope are the changes in nerve function in all 



THE EFFECTS OF ALCOHOL ON NERVE TISSUE. 95 

parts of the nervous system. These are first to be noticed 
in the psychic domain, and the ethical side of the alco- 
holic's character is the first to exhibit the deterioration. 
These are almost imperceptible at first and take the form 
of simple irritability. Trifles annoy him. Petty displeas- 
ing incidents which would have passed unnoticed in his 
normal condition now call forth expressions of anger 
out of all proportion to the importance of the incident. 
The alcoholic himself recognizes this unfavorable change 
in his disposition; but, instead of giving up the drink 
which causes it, he seeks relief in the narcotism afforded 
him by increased potations. While in this condition he 
is apt to regret his impatience. He seeks out those friends 
to whom his irritability may have given offense and apol- 
ogizes with profuse and often maudlin volubility. 

Later he grows suspicious of those around him, thinks 
that he is neglected by his friends and that he is not ac- 
corded a just measure of gratitude for favors he may 
have done them, and is liable to attach a great deal of 
importance to a trifling act of this kind done by him. If 
his friends notice the change in him and warn him that 
he is injuring himself with drink, instead of giving due 
heed to the advice, he is liable to consider this an infringe- 
ment on his personal liberty, an unwarranted interference 
with his private affairs, and he will resent it to the extent 
of putting a friend of a score of years on the list of his 
enemies. 

The moral sense suffers enfeeblement and deteriora- 
tion. He who was once so punctilious in the matter of 
meeting his daily obligations becomes evasive and neg- 
lectful. That nice discrimination with which he formerly 
met and promptly attended to the various complicated 
questions of social and business ethics is lost, and 
his mind is seen to be of a distinctly coarser fiber. 



96 SHALL WE DRINK WINE? 

Sense of dignity, of honor, of moral obligations, of per- 
sonal conduct, no longer move him as formerly. He 
thinks only of escaping from them, for the weakened 
brain cells are no longer capable of attending to such 
things without infinite labor which the will power of the 
alcoholic is no longer able to command. The ego be- 
comes prominent, but it is an ego of very inferior order. 
He talks much of himself — what he is, what he can do, 
and is anxious to gain the ear of anyone who will listen 
to his long rambling imbecile narrations of which he is 
himself always the hero. 

Oftentimes the character of the inebriate is so com- 
pletely the opposite of that of the same man when sober 
that one marvels at the possibility of both dwelling in the 
same individual. A man of affairs upon whose shoulders 
rests the responsibility of successfully directing an in- 
vested capital of hundreds of thousands of dollars, does 
it with an insight and comprehensive grasp of detail 
worthy the brain of a field marshal. He is an important 
social factor, too, and his influence is felt along scores 
of complicated lines of beneficial action. At home he is 
a loving husband and father, and abroad he is a gentle- 
man of modest unaffected manners so brilliant and genial 
that it is a pleasure to be in his society. In his personal 
habits he is strictly correct, and he carries himself with 
the confident air of one who is a complete master of him- 
self and affairs. Let this same man be drunk on alcohol 
every day for a year, and the degenerative changes in the 
brain cells make him a being so much lower in the scale 
of social evolution that he might be regarded as belong- 
ing to another and infinitely lower race of men. He has 
not only lost his power to direct great business ventures, 
but he has no desire to do anything of the kind. All of his 
ambitions are now represented by an intense desire to 



THE EFFECTS OF ALCOHOL ON NERVE TISSUE. 97 

get sufficient alcohol wherewith to relieve the physical 
and mental anguish induced by even a short abstinence. 
Friends have long since been forgotten, and family ties 
probably broken by neglect or even hatred on the drunk- 
ard's part. His conversation is now the maudlin obscen- 
ity of the bar-room, and his associates are the fallen men 
and women who live by the petty crimes committed in 
theirs, the lowest stratum of any kind of human society. 
His personal appearance has suffered no less than his 
character, and his unkempt, neglected, shuffling figure 
and repulsive expression are a fitting index of the brain 
degeneration produced by the long contact of its cells with 
alcohol. 

Finally the alcoholic reaches the condition of real in- 
sanity. He is emotional in a morbid degree, intensely 
self-conscious, fault-finding, perverse, intolerable of con- 
tradiction, and easily aroused to violent passion. He 
may, on the other hand, become indifferent to his sur- 
roundings, falling into a condition of stupidity from which 
nothing, for the time, will rouse him, or he may fall "into 
a condition of simple imbecility. 

It is a well-known fact that the will power is early and 
profoundly affected in alcoholism. The subject loses the 
power to control his own actions and he is willing to be 
led by very slight influences. Recognizing his duties, he 
finds it impossible to perform them, impossible to reach 
and carry out any plan of action requiring vigorous 
thinking. The indifference with which he regards his 
daily duties, with an inability to perform them, gives rise 
to a distaste for all the occupations in which he was 
formerly engaged. 

Last to fail, as a rule, is intellectual power. It may 
show itself after prolonged excessive indulgence, even 
after the body is become a wreck. Sometimes it is, in a 



98 SHALL WE DRINK WINE? 

fitful way, present to the last. Failure of the intellect is 
generally first observed as a loss in power to quickly 
grasp an idea, a loss of vivacity, an evidence that all men- 
tal processes are performed more slowly and laboriously. 
The drunkard is indifferent to all social and other ques- 
tions which give interest to the lives and intercourse of 
the healthy. His conversation is broken and his ideas 
fragmentary. Finally the memory fails in a marked de- 
gree, and he soon reaches a stage of mental degeneration 
which renders him unfit for any useful calling. 

The above sketch touches only a small part of the 
phenomena due to the continued use of large quantities 
of alcohol. Organic changes in the viscera, the digestive 
tract, liver, heart and other organs complicate in a thou- 
sand ways mere nerve degeneration, giving the disease 
picture an almost kaleidoscopic aspect; moreover, there 
are hereditary influences at work which are aroused by 
indulgence in alcohol and contribute their part in modi- 
fying the surface play of alcoholic degeneration. 

Of disturbances relating to the special senses, hal- 
lucinations of sight are common, hallucinations of hear- 
ing sometimes present, as are also those of smell and 
taste. Of sensation, anesthesia or hyperesthesia may be 
present, as well as abnormal sensations of heat or cold. 
Amblyopia is common, probably from the degeneration 
of the cortical cells. 

Disturbances of motion in chronic alcoholism is com- 
mon, and may assume a variety of forms and different 
grades of severity from slight ataxia with numbness to 
almost or quite complete paralysis. In my experience 
the lower limbs are oftener affected than the upper, and 
the feet the most usual site both of sensation and motion 
anomalies. The arthrodynia described many years ago 
(New England Journal of Medicine and Surgery, 1822,) by 



THE EFFECTS OF ALCOHOL ON NERVE TISSUE. 99 

James Jackson, is prominent in many cases. The pains 
are persistent and at times excruciating, accompanied by 
a feeling of numbness which causes the patient much 
anxiety. Progressive atrophy of the muscles, especially 
of the extensors, takes place, causing a contraction of 
the flexors to such a degree that from this and the paralysis 
the patient may be entirely crippled. Many other writers 
have noticed these changes since Jackson wrote of them, 
notably Lancereaux, Huss, Wilks and Dreschfeld. 

A typical but mild case of alcoholic paralysis is now 
under my care, and I cannot do better than give a com- 
plete history of the course of the disease as exhibited in 
him. This man is now forty years of age, and up to 
eighteen months ago had been addicted to periodic alco- 
holic excesses ever since he was seventeen years old. 
With increasing years his excesses increased until about 
three years ago, at which time he "took a course" in a 
commercial institution for inebriates. For a year after- 
wards he drank no alcoholic liquor excepting an oc- 
casional glass of beer. He felt well at this time and at- 
tended to his duties as bookkeeper in a lumber yard for 
several months, and was able to do his work well and 
without unusual fatigue. He then began to drink large 
quantities of whisky and brandy, his daily average for 
a period of seven or eight months being a quart or more. 
He is able to tell exactly how much he drank, for he 
bought the liquor by the gallon. 

He came under my care, in the present instance, only 
two months ago; I cannot, therefore, speak accurately of 
his condition just after he ceased taking this enormous 
quantity of alcohol. From what he says, however, I judge 
that his present condition of ataxia or paralysis is as it 
was at that time only in a less degree. The parts involved 
are the right knee and foot and to a less degree the right 



103 SHALL WE DRINK WINE? 

shoulder. He has had almost continuous pain and sore- 
ness of the right knee extending down the leg to the foot, 
associated with a feeling of numbness and formication in 
sole of the- foot. He is troubled a great deal by a sense 
of insecurity of the affected member. If he happens to 
step with the heel upon a projecting knot or other prom- 
inence in the way, his knee is liable to give way and cause 
him to fall. The sensation as he describes it is like that 
one experiences when he attempts to walk when his foot 
is asleep. The shoulder is not so painful as the knee, 
and the hand shows none of the anomalies of the foot. 
The muscles are not apparently atrophied. He complains 
of uneasiness in the region of the right cerebellar lobe, 
accompanied by a dull ache; and, when he looks upward, 
he has a sensation of dizziness and inability to retain his 
equilibrium, indicating a possible degeneration of a cell 
area in the cerebellum. 

Two other cases similar to this case occurred in my 
experience a few years ago. In one paralysis was bilateral, 
almost complete, and affected only the lower extremities. 
In the other only one lower extremity was affected and 
here the pain and anesthesia were more prominent than 
the paralysis. A peculiarity of the first case cited is the 
long continued persistence of the ataxic symptoms after 
the alcohol is given up; for in all the other cases which 
I have observed the withdrawal of the alcohol was attended 
by rapid progress toward recovery. 

Degenerative changes in the peripheral nerve filaments 
have been described by Leudet, Dreschfeld, Lancereaux, 
Dejerine and others. Huss was unable to find any 
changes in the five cases dead of alcoholic paralysis. 

Where the peripheral nerve filaments suffer degen- 
erative changes it is difficult to say how much is due to 
direct alcoholic irritation and how much to lack of nutri- 



THE EFFECTS OF ALCOHOL ON NERVE TISSUE. 101 

tion. The recent researches of Hoch (Loc. Cit.) showed 
that while the nerve cell might be profoundly degener- 
ated the axis cylinder was apparently unchanged. Rea- 
soning from this, we might conclude that the peripheral 
nerves may not be directly affected by alcohol. 

The evil effects of alcohol upon the rapidly develop- 
ing tissue cells of the entire organism in childhood deserve 
special attention. Here, protoplasm activity, as is the 
case in embryonic tissue and the nervous tissue of the 
adult, invites alcoholic destruction; therefore small quan- 
tities of the poison have a relatively greater influence than 
upon the organism of the adult. 

Excepting among the most vicious classes in the over- 
crowded tenement districts in our large centers of popu- 
lation, the stronger alcoholic liquors are seldom given 
to children as a beverage. Among foreign born parents, 
however, a not inconsiderable quantity of alcohol in the 
form of beer and wine is daily given to children from a 
few months of age upwards. 

As a remedy, however, the ever present brandy bottle 
has been a panacea in the ordinary household for all kinds 
of slight digestive troubles incident to childhood, even 
children in the cradle having a little lime-water and brandy 
put in their nursing bottles to correct "acidity" and give 
strength to the little victim of mal-nutrition. This form 
of domestic medication, having the authority of medical 
books and medical men, may go on for weeks and months, 
and the seemingly small daily quantity may do an incal- 
culable amount of harm to the already weakened tissues 
of the tiny patient. Demme cites (Einfluss des Alkohols 
auf den Organismus des Kindes, P. 48, et seq.) two cases 
of real alcoholic sclerosis of the liver in boys, four and a 
half and eight years of age respectively, the first of which 
was given whisky for colic, and the latter received it as 



102 SHALL WE DRINK WINE ? 

a stimulating tonic. Both cases, of course, terminated 
fatally. Many cases of lack of mental development from 
the same cause, are mentioned by the same author; and 
of particular interest are several cases of epilepsy, typical 
in all respects, the origin of which could be directly traced 
to the poisonous influence of alcohol upon the impres- 
sionable tissues of childhood. Cases of epileptic attacks, 
eclampsia, chorea, and many other nervous disturbances, 
mild and severe, directly resulting from the exhibition of 
alcohol in the early years of life, might be cited. 

Other writers in recent years have raised a warning 
voice against the administration of alcohol to children, 
and especially against allowing them to drink any kind 
of alcoholic beverage. Professor Nothnagel (Verhand- 
lungen des VII. Congresses fur innere Medicin, Wies- 
baden, 1888, P. 137,) characterized the giving of wine at 
the table to children of three or four years of age as "a 
cancer of our age." 



X. 

"Che Influence of Hlcobol Upon Bmbryontc Ossue 
and F)eredity. 

The action of alcohol upon the rapidly growing cells 
of the embryo is undoubtedly more destructive than upon 
mature tissue, if we are permitted to reason from analogy. 
It is easy to understand that the protoplasm of cells which 
display great activity, even if that activity is only vegetative 
in character, must be in a condition of great physiological 
irritability, needing only a comparatively weak stimulus 
to push it beyond the limits of normal activity to cell 
destruction. We may compare the irritant action of al- 
cohol with the ordinary irritation seen in inflammatory 
processes, in which irritation may be only sufficient to 
stimulate an increase in new tissue, or the process may be 
so energetic that the tissue is broken down, as is seen 
in the ordinary process of suppuration. The embryonic 
cell already possessing a high degree of the same irrita- 
bility which results from all inflammatory processes, it 
needs only a comparatively small amount of stimulation 
to accomplish its destruction. Moreover, the narcotic 
effects of alcohol must play an important part in hinder- 
ing the normal course of the biochemical processes nec- 
essary to physiological cell integrity. 

In the work of Dr. Wilkins (Loc. Cit.) the adminis- 
tration of alcohol was supplemented by fifty-one post- 
mortem examinations, from which he concludes that the 
cell walls enclosing the germinal matter are dissolved, the 



104 SHALL WE DRINK WINE ? 

albumen not in combination coagulated, the red blood 
corpuscles are deprived of their constituents, which mingle 
with the liquor sanguinis, leaving them shrunken and 
wrinkled, and the organizing ability of the protoplasm 
is modified. The result is to fill up the connective spaces 
with foreign compounds favoring the growth of tumors 
and neoplasms. Chemical selective power is either im- 
paired or completely destroyed, rendering wounds dif- 
ficult to heal. Two conditions cause this. In the first 
place, although there is an abundant proliferation of pure 
germinal matter, it cannot be organized because of the 
degeneration above mentioned, but proceeds to further 
degeneration into pus cells because of the continued irri- 
tation. Secondly, metabolic life is suspended because the 
ganglions are deprived of phosphorus and protagon by 
the direct solvent action of alcohol. Thus the neuro- 
dynamia in the grey matter is not properly organized, 
the enlarged soft parts disintegrate and neoplasm forms 
in the wounds, while the broken bones receive no osteo- 
blasts to repair damage. 

Fere reported a series of very interesting experiments 
(Journal of Anatomy and Physiology, Paris, March and 
April, 1895,) in which he undertook to demonstrate the 
effects of direct contact with alcohol with the bird embryo. 
For this purpose he dosed a number of hens' eggs with 
small quantities of alcohol before placing them in position 
for incubation. Several living chickens were hatched out 
at the end of twenty-one days, but the most of them were 
not ready, at the end of that time, to leave the shell because 
of insufficient development, a large yolk being still re- 
tained. Some were killed by the alcohol, and those which 
were not could not leave the shell before the twenty-third 
day. Of peculiar interest was the fact that many of the 
young birds presented various anomalies and monstrosi- 



INFLUENCE UPON EMBRYONIC TISSUE AND HEREDITY. 105 

ties, such as deficiencies of the abdominal wall, double 
terminal phalanges and nails, crossed beaks and the like. 
One of the birds was an epileptic and all might be regarded 
as alcoholic degenerates. 

Fere's experiments also show that alcohol vapors ar- 
rest the development of the embyro in the egg of the 
fowl, and he believes that these results prove that the same 
obtains in the case of alcoholism in the human subject. 

That the progeny of lower animals show the degen- 
erating effects of alcoholic parents is a matter which is 
engaging the attention of some experimental physiolo- 
gists at the present time. Of great interest in this con- 
nection are the experiments conducted by Professor C. F. 
Hodge of Clark University. The subjects of his experi- 
ments were two pairs of Cocker spaniels, healthy and 
of the same age, the males being brothers and the females 
sisters of distantly related parentage. One pair received 
a daily supply of alcohol, but not sufficient in quantity 
to noticeably intoxicate. The other pair received the 
same kind and quantity of food but no alcohol. Nine 
litters of puppies were born to each pair, those of alco- 
holic parentage numbering 20 and those of non-alcoholic 
parentage 16. Of those born of the alcoholized parents 
6 were born dead and 8 had some sort of malformation, 
only 4 being healthy. To the non-alcoholic parents 1 was 
born dead, and only 1 was malformed, the remaining 15 
being perfectly healthy. In other words, only 20% of 
the progeny of the alcoholized parents were healthy, while 
93.8% of the progeny of the non-alcoholic parents were 
healthy in all respects. This result agrees very closely 
with the results of Demme's ten alcoholic and ten sober 
families. 

Reasoning from the destructive influences of alcohol 
upon protoplasm in general and upon the extremely active 



106 SHALL WE DRINK WINE? 

protoplasm of the embryo particularly, we are prepared 
to understand the evils which may be transmitted by the 
alcoholic parent to his offspring, long ago recognized by 
observing medical men. So many observations of this 
kind have been made that anything like a complete rec- 
ord of them would consume much more space than may 
be given to that subject in this work. More than twenty- 
five years ago Alexander Bain, the psychologist, expressed 
a belief, as the result of evidence he was able to collect, 
that no child conceived while either parent was in a con- 
dition of alcoholic intoxication could be perfectly sound 
mentally and physically. This is, no doubt, an extreme 
view, for we must admit the force of modifying circum- 
stances, such as other hereditary influences in the parents 
aside from alcoholism, the amount of damage done to the 
tissues at the time conception took place, and whether 
both parents were alcoholic habitues. In short, the 
actual amount of damage done to parental tissue as a 
whole by the continued use of alcohol ought to be an in- 
dex of the amount of deviation from the normal standard 
of health exhibited by the child. It ought not to be for- 
gotten that the heritage of alcoholic degeneracy usually 
descends through only one parent, the father; the mother, 
in America at least, being almost always free from ac- 
quired alcoholic taint. There should be, therefore, in cases 
in which the mother is sober and herself free from hered- 
itary taint some chance of producing normal, healthy prog- 
eny. As a matter of fact, instances of the kind are common 
in the experience of every one who has taken the trouble 
to make the necessary observations and investigations. 
Many instances might be recalled of strong, sound, force- 
ful, mature young men and women who are the sons 
and daughters of drunken fathers. As to whether alco- 
holic degeneracy may leave the next generation unmo- 



INFLUENCE UPON EMBRYONIC TISSUE AND HEREDITY. 107 

lested and reappear in the second or third, no definite 
observations, so far as I am aware, have yet been made. 
The difficulties attending the collection of statistics of this 
nature are necessarily so many and so great that no val- 
uable conclusion could be arrived at. 

Wilson of Kansas City (New York Medical Journal, 
Sept. 22, 1894,) thinks that if conception takes place at 
the time when one or both parents are in a condition of 
alcoholic intoxication or have been in that state for a 
time sufficient to cause a deficiency in the nerve centers 
there will be a corresponding deficiency in the child. 
Not that all the children of alcoholics are weak-minded 
or idiots; but, when the conditions exist as stated above, 
a weak mind or idiocy is the result. 

Haushalter of Nancy gives an interesting case of alco- 
holic degeneracy exhibited in the offspring of a chronic 
drunkard (Revue Medical, Paris, July 10, 1894). The 
father is forty years old and shows all the outward signs 
of an excessive habitual consumer of alcohol. The 
mother of about the same age looks worn and many years 
older; she, however, never had any specific disease. The 
first male child was born dead. The fourth, seven and 
a half years old, was brought to the hospital in a wretched 
state. Although fully developed, strong, and robust at 
birth, he is now pale, emaciated, and with a dry scaly skin. 
The child is addicted to vicious habits, silent, morose, and 
terrified, crying upon the slightest occasion. Haushalter 
expressed his belief that the deplorable moral and phys- 
ical degeneration is due to the fact that the child is 
"the last born of an alcoholic father." 

Personally I have come in contact with many cases 
of inherited degeneracy from an alcoholic father as strik- 
ing as this cited by Haushalter. Space will permit a 
description of only a few and I select four families well 



108 SHALL WE DRINK WINE? 

known to me as fairly representative cases of inherited 
alcoholic degeneracy. 

First family: Father a drunkard for twelve years. 
No hereditary taint in father as far as could be ascer- 
tained. Two sisters and one brother sober and useful 
members of society. Drank to excess from time of his 
marriage until fourth child was born excepting an inter- 
val of about two years. Cessation of drink during this 
period was due to removal into an isolated settlement 
where intoxicating drinks could not be procured without 
much difficulty. 

First child female, well developed and healthy in early 
childhood. Later became nervous and anaemic and had 
two attacks of chorea before puberty. With appearance 
of puberty asthma developed accompanied with various 
psychic disturbances, periodical nervous excitement, hys- 
teria and melancholia. 

Second child, male, was a typical degenerate mentally. 
Given to attacks of violent passion and rage, cruel to ani- 
mals and children whose weakness made it safe for him 
to bully them, intractable at home and at school, with the 
appearance of manhood he committed some punishable 
offense and was obliged to seek safety in flight, from 
which time he passed from under my observation. So 
far as I know he was not addicted to alcoholic drink at 
the time of his escape. 

Third child, female, still born. 

Fourth child, male, fairly well developed and in good 
health. When last seen he was seventeen years of age 
and his steady going habits were often the subject of 
remark by his degenerate elder brother. It is interesting 
to note that this child was born less than six months after 
his father again began his alcoholic excesses, which ter- 
minated fatally in three years. 



INFLUENCE UPON EMBRYONIC TISSUE AND HEREDITY. 109 

The fifth child, born two years after the fourth and 
while the father was in a condition bordering on alcoholic 
imbecility, was an interesting study. He was under ob- 
servation from the time he was eight years of age until 
his fifteenth year. As a child he was well nourished and 
healthy in appearance, but walked with the uncertain 
gait of a mildly choreic subject. This incoordination 
affected the muscles of the upper extremities, though in 
a less degree, and the child's speech was halting and 
stammering. At school he was timid, lacking self-con- 
fidence in his classes and seeking the constant compan- 
ionship and protection of his more robust elder brother. 
He learned rapidly and was very faithful to his school 
work; with increasing years the incoordinated movements 
became less marked, possibly from greater efforts to con- 
trol them, but when last seen they were still to be noticed, 
especially when he was excited. 

Second family: Father and mother of good heredity, 
have seven children. The first four, born while the father 
was sober and prosperous, are in good health and have 
had no disease except the ordinary diseases of childhood. 
After the birth of the fourth child the father became a 
drunkard, since which time three children have been born, 
not one of which exhibits the strength of any of the first 
four. All are nervous, have nutritive disturbances, and 
the youngest exhibits signs of hydrocephalus. 

Third family: Father a drunkard, heredity un- 
known, has no alcoholic excesses, but drinks a small 
quantity of beer occasionally. Mother at the time of her 
marriage to present husband had one healthy female 
child. Two children resulted from the second union, 
both male; one appears to be in a normal condition of 
health, but the younger one is idiotic and has recently 
been sent to a home for the feeble-minded. 



110 SHALL WE DRINK WINE? 

Fourth family: Heredity of mother unknown, hered- 
ity of father good. Mother's habits good, but father has 
been a drunkard ever since his marriage and before. 
Two children have been born to them, both of whom 
exhibit trophic disturbances in a marked degree. The 
elder child is one of the most restless and irritable I have 
ever seen, and exhibits frequent excessive emotional 
storms, is of poor color, emaciated, sleeps poorly, and in 
many other ways shows profound nervous disturbance. 
The other child is a victim of mal-nutrition amounting 
to marasmus, and has been beset by adenoid vegetations of 
naso-pharynx and larynx which twice rapidly reappeared 
after their removal from the pharynx. So conspicuous 
were the trophic changes in the case that a colleague dis- 
cussed with me the probability of an existing specific 
taint, but we could find absolutely no evidence to war- 
rant that conclusion. 

That there is an hereditary alcoholic degeneracy mani- 
fested by an abnormal desire for alcoholic drink without 
serious physical or mental disturbances seems to be sup- 
ported by good evidence. A case in point is that of a prom- 
inent and intelligent man of affairs, under my care at vari- 
ous times for alcoholic excesses, who finally died of alco- 
holic cirrhosis of the liver. He gave a very detailed account 
of the alcoholic family of which he was a member, for 
three generations. His paternal grandparents were both 
drunkards and all his paternal uncles and aunts, with 
the exception of one of the latter, drank to excess. In 
his immediate family, the father and two brothers were 
drunkards, while a brother and a sister only were sober. 
He declared to me also that his little children, girls six 
and nine years old respectively, at that time, had already 
exhibited the consuming desire for strong drink which 
had characterized so many members of his family. He 



INFLUENCE UPON EMBRYONIC TISSUE AND HEREDITY. Ill 

described his own desire for drink as absolutely uncon- 
trollable. His excesses were periodic at first, and when 
the desire seized him absolutely nothing but the fact that 
to secure drink was a physical impossibility would pre- 
vent him from satisfying his morbid appetite. 

Another case of transmitted morbid appetite without 
other disturbance mental or physical was that of a young 
man whose mother drank large quantities of brandy dur- 
ing his intra-uterine life. This woman was of good par- 
entage and surroundings and had never taken any alco- 
holic drink of any importance until her first pregnancy. 
At this time her desire for alcohol assumed the form of 
a morbid longing characteristic of her condition. Her 
husband was absorbed by his business affairs and she 
was left to gratify her morbid appetite at will. This she 
did until her son was born, after which she had no further 
desire for alcohol. Excepting an indefinite history of 
"nervousness" the boy exhibited no abnormal tendencies 
until the age of puberty was reached. At this time he 
evinced an intense liking for all kinds of liquors, and in 
early manhod became a confirmed sot. When last seen 
by me he had reached a condition of idiocy, and I learned 
of his death soon afterward. 

Of statistical evidence showing the blighting effects of 
alcoholism in the parents upon the offspring, that recently 
reported by Legrain is most instructive (Medical Press 
and Circular, London, Jan. 13, 1894). This report in- 
cludes vital statistics of 215 alcoholic families represented 
by 819 descendants. Of this number 16 were born dead, 
37 were born prematurely, there were 121 premature 
deaths, generally attended by convulsions, 55 cases of 
tuberculosis, 38 cases of marked physical debility, and 145 
cases of mental derangement. Of the remainder, "a large 
number were epileptics, hysterics, idots, etc." These ob- 



112 SHALL WE DRINK WINE ? 

servations were made in France and the author attributes 
the rapid depopulation of that country to the great increase 
in alcohol consumption, or, rather, he considers this as of 
prime importance as a cause of the depopulation of France. 
Hitherto the French have been regarded as a sober peo- 
ple, but they deserve that reputation no longer, for in 1892 
they consumed nearly 40,000,000 gallons of alcohol. In 
1789 France was the most thickly populated country in 
Europe, representing 27 per cent, of the entire European 
inhabitants. To-day she represents only 12 per cent, 
the excessive death rate being infantile. During the ten 
years preceding 1894, 42,000 children were still-born and 
240,000 children between the ages of one and five have 
died annually. Apart from other causes contributing to 
this result, great prominence is, by general consent, given 
to alcohol. This has been occasioned largely by the in- 
creasing manufacture of wine charged with impure alcohol. 

Legrain emphasizes the fact that drunkenness is a 
fertile cause of unhealthy issue. The simple condition of 
drunkenness at the time of conception is sufficient to cause 
mental and physical inferiority in the offspring. This 
degeneration in the children of alcoholics may result even 
though neither parent may be actually under the influ- 
ence of alcohol at the time of procreation. 

Forel is convinced that chronic alcohol poisoning in 
the parents is transmitted to the offspring in the form of 
various mental and physical anomalies (Medical Pioneer, 
Endfield, Eng., Nov., 1893). The heritage may descend 
in the form of an irresistible craving for alcohol, physical 
debasement, mental disease, idiocy, and a multitude of 
other disturbances. Hereditary craving for alcoholic 
drink may exist when neither parent drank from any other 
motive than that of sociability. He found, too, that these 
abnormal descendants bear alcoholic liquors badly and 
are easily intoxicated. 



INFLUENCE UPON EMBRYONIC TISSUE AND HEREDITY. 113 

Vigillis of Italy (ibid.), discussing the heritage of 
criminals, says that 32 per cent, of all criminals have 
criminal tendencies as a direct inheritance from their par- 
ents, and that alcoholism in the ancestry is a most fruit- 
ful cause of criminal tendencies. Corre of the French 
military service (Quarterly Journal of Inebriety, Jan., 
1894,) believes that 40 per cent, of crime and reprehen- 
sible conduct comes from inherited alcoholic degenera- 
tion from inebriate parents. 

C. H. Hughes of St. Louis (Alienist and Neurologist, 
Jan., 1894,) recalls Morel's table of alcoholic neuropathic 
degeneration extending through four generations as fol- 
lows: 

FIRST GENERATION: Immorality, alcoholic ex- 
cesses, brutal degradation. 

SECOND GENERATION: Hereditary drunken- 
ness, maniacal attacks, and general paralysis. 

THIRD GENERATION: Sobriety, hypochondria, 
lypemia, maniacal attacks, and general paralysis. 

FOURTH GENERATION: Feeble intelligence, 
stupidity, first attacks of mania at sixteen, transmission 
of complete idiocy, and probably extinction of family. 

More recently Legrain presented in the British Med- 
ical Journal a great many observations which, when tabu- 
lated, lead him to draw the following conclusions: 

(1) Double parental alcoholism creates an irresisti- 
ble tendency to drinking in children. 

(2) Parental absinthe drinking seems to directly 
transmit epilepsy to the offspring. 

(3) Parental combination of absinthe drinking and 
epilepsy is a common cause of epilepsy in children. 

Fuerer of Heidelberg (Bulletin Medical, Paris, Aug. 
25, 1895,) expresses the doctrine that the generative cells 
of the drunkard are alcoholized and that the offspring are, 



114 SHALL WE DRINK WINE? 

for that reason, frequently degenerates: psychopathies, 
idiots, or rachitics. He makes a distinction between those 
cases in which there is only an inherited desire for drink 
and those in which there is some inherited organic fault. 
He admits, however, that one form may coexist with or 
engender the other, both being the result of real degen- 
eration. He thinks it absurd to think that an evolution- 
ary adaptation of the human kind to alcohol will ever be 
brought about, insuring it immunity against alcoholic 
poisoning. Facts prove the contrary. The intoxication 
of the male and female germs weakens the resisting force 
against alcohol in the descendants instead of strengthen- 
ing it. It is impossible for an evolutionary adaptation to 
narcotic poisons to take place. 

Speaking of the influence of alcoholism in producing 
degenerative offspring, Crothers (Journal of American 
Medical Association, April 9, 1898,) remarks that heredity 
has in these cases left the person a low and defective vital- 
ity, feeble powers of resistance, and inability to adjust 
himself to his surroundings. These conditions of weak- 
ness and degeneration diminish the power of resistance 
against inflammatory disease, and also make narcotism by 
alcohol fascinating because the subject thus acquires a 
feeling of strength and his physical and mental distress 
are at the same time relieved and deadened; moreover, 
the families of inebriates and consumptives are often very 
numerous. Where the degradation of the parents is un- 
mistakable, the number of children is often very large, 
confirming the oft noted fact that just before extinction 
of the race a supreme effort is made to perpetuate the 
seed and save it from obliteration. While the inebriate 
families are often large, they die young. If they live 
through childhood, they carry with them into maturity 
defects which soon cause their extinction. Several cases 



INFLUENCE UPON EMBRYONIC TISSUE AND HEREDITY. 115 

illustrating this are cited. Two degenerate members of 
a famous family in New York united, both of whom were 
moderate drinkers. Thirteen children were born, five 
of whom died in infancy, and eight reached the age of 
maturity. Three of this number were drunkards and 
died of tuberculosis, one died of acute pneumonia, one 
became demented, and two died with some low fever asso- 
ciated with rheumatism. The one still living has been 
eccentric and feeble-minded all his life. Not one of the 
descendants of these people is living. Of another family, 
three of the nine members came for treatment for inebriety, 
one relapsed and became insane, the second was killed by 
accident, the third is a low drunkard. Two of the remain- 
ing children died of tuberculosis, one is an eccentric re- 
former with extreme zeal, but little wisdom, and one is 
a paranoiac single woman. The parents were healthy 
drinking people, without business, who died in middle 
life of some acute disease. 

Degenerate families of this kind are by no means 
uncommon, especially in older sections of the country. 
They appear in the two extremes of great fecundity or 
barrenness. When a general history shows that the family 
is degenerating, growing weaker in appearance and con- 
duct retrograding, tuberculosis and inebriety with hys- 
teria, eccentricity, rheumatism, and a variety of nerve 
diseases are almost sure to follow. Members of such 
families are sometimes brilliant and precocious. A son 
of one of these dying families took high honors at col- 
lege and entered upon a brilliant professional career, in 
which he became eminent; but two years later he became 
an inebriate and died of tuberculosis. His inherited de- 
generation had been masked by his display of vigor and 
precocious brilliancy. 

Baer has pointed out that in sections of the country 
given to excessive drink there is a smaller percentage 



116 SHALL WE DRINK WINE? 

of young men fit for military duty than is to be found 
in those parts in which the people are temperate, and 
Gyllenskiold says that since the full benefit derived from 
the recently enacted laws regulating the sale of intoxicants 
in Sweden has become apparent, there is a smaller num- 
ber unfit for military service because of physical weak- 
ness and low stature, than before these laws were enacted. 

In an address delivered in 1874 by the Director of the 
Council of the Canton of Bern in regard to the manage- 
ment of a model distillery, the evil done by this institu- 
tion was described in the following words: "In our Can- 
ton, without any difference in age or sex, the consumers 
of spirits have so largely increased that it furnishes an 
explanation as to why the large, strong, fresh, fine figures 
are becoming more rare, why the recruit transports con- 
tain so many small, bent, prematurely old individuals 
with expressionless, yellow, stupid faces, and why the 
number of acquired and not congenital nervous diseases 
is increasing." (From Demme's Einfluss des Alkohols 
auf den Organismus des Kindes, Pp. 35 and 36.). 

In Demme's comparison of ten families of drunkards 
with ten families whose members were temperate their 
life histories disclosed the following facts: Of the ten 
drunken families there were 57 direct descendants. 25 
of these died in their first year of insufficient vitality, 6 
were idiots, 5 were dwarfs, 5 epileptics, 1 choreic and 
idiotic, and 5 had hydrocephalus, hare-lip, and club foot. 
Two of the young men were epileptic and had inherited 
alcoholism. Only 17.5 per cent, had ordinary good 
health in childhood. Of the' temperate families there were 
61 direct descendants. Only 5 died in infancy of con- 
genital lack of vitality, four had curable nervous diseases, 
and two more had some congenital defect. 81.5 per cent, 
were mentally and physically sound in childhood and 
youth. 



XL 

Hlcobol as a factor in the production of 
Insanity* 

From the evidence cited above the conviction that 
alcohol is an important causative factor in the produc- 
tion of insanity cannot be avoided. It is extremely dif- 
ficult, however, in the vast majority of individual cases, 
to determine exactly how much of the disturbance may 
be charged to alcohol, either directly or indirectly, and 
how much to other causes near or remote. In order to 
reach anything like a correct conclusion, a history of 
the direct and collateral family ties of each person, for 
at least three generations, would be absolutely necessary, 
and this should be supplemented by a minute personal 
history from infancy until the onset of the mental dis- 
turbance. While the latter may sometimes be approxi- 
mately or quite complete, the former is rarely or never 
complete enough to be of definite value for the purpose 
of fixing alcoholic responsibility. Furthermore, recog- 
nizing the difficulty of obtaining such ancestory statistics, 
superintendents of hospitals for the insane have probably 
paid little attention to the matter, and there are available 
no records of even the small number of cases the histories 
of which might have been obtained with a valuable degree 
of completeness. 

One of the foremost statisticians in the United States 
(Dr. Frederick Wines) writes me that he has no statistics 
on the subject; and those he has seen were not trust- 



118 SHALL WE DRINK WINE ? 

worthy. Another writes me that he is now collecting 
evidence of this kind, but that it will be many months 
before it is analyzed. From a letter received from a third 
I quote the following paragraph: "We have very little 
literature on the subject. During the last year in this 
institution there were 409 admissions. Fifty-four cases 
were recorded as intemperate. There were probably 15 
cases in which this was not given as a cause that I per- 
sonally know to have been intemperate, and I have no 
doubt that there are others in which the use of alcohol 
was an etiological feature and was not set forth in the 
examination papers" (Dr. W. A. Gordon, Northern Hos- 
pital for the Insane, Wis.). In letters from several 
other superintendents of insane hospitals, no statistics of 
the kind are available. Of course the mere fact that an 
insane person had been addicted to alcohol in excessive 
quantities is of small importance in determining the cause 
of his insanity unless he could prove a good inheritance 
and sound health up to the time of his alcoholic excesses ; 
for, as we have seen, alcoholism may be an effect as well 
as a cause of central nervous disturbance. 

A committee is now engaged in collecting statistics 
upon alcoholism and insanity, but statistical evidence of 
this kind is of slow growth, and many years must elapse 
before it can assume a definiteness and proportion suffi- 
cient to make it of value. The most complete statistics 
on the subject of alcoholism are those collected by the 
authority of the state of Massachusetts for the year end- 
ing with August 1st, 1895 (Twenty-sixth Annual Re- 
port of the Bureau of Statistics of Labor). There were 
confined in state institutions for the insane 1,836 persons, 
974 of whom were males and 862 females. In point of 
age, only 78 were under twenty years. The decade hav- 
ing the greatest number was that between thirty and forty, 



ALCOHOL IN THE PRODUCTION OF INSANITY. 119 

there being 457 of that period. The next greatest num- 
ber occurred between twenty and thirty — 405, while 2>7 2 
occurred between the ages of forty and fifty, 235 being 
fifty and sixty, 254 between sixty and eighty, while only 
30 were beyond eighty years of age. 

Of the whole number of insane (1836) 311 were said 
to be excessive drinkers before the occurrence of insan- 
ity; 360 were moderate drinkers, while 6jJ were total 
abstainers. The habits of the remaining 488 with regard 
to alcoholic indulgence could not be ascertained. It will 
be seen, therefore, that 16.94 per cent, of the insane were 
excessive drinkers, 19.6 per cent, were moderate drinkers, 
and 35.87 per cent, were total abstainers, while from 26.58 
per cent, of the whole number no information upon this 
point could be obtained. 

Subtracting those cases of whom no information could 
be obtained regarding habits of alcoholic indulgence, there 
remained 1,348 whose habits were known, 699 of whom 
were males and 649 females. Of these known cases, 3548 
per cent, of the males were excessive drinkers and 26.32 
were total abstainers; while of the females 10.02 per cent, 
were excessive drinkers and 75.96 per cent, total abstain- 
ers. 

Information regarding the habits of the parents as to 
indulgence in alcoholic beverages could not be obtained 
in 939 or 51.14 per cent, of the cases. In 616 cases, 
comprising 316 males and 300 females, one or both par- 
ents were intemperate, while in 281 cases, 128 males and 
153 females, one or both parents were total abstainers. 

As to whether the inmates' insanity was directly due 
to the excessive use of alcoholic beverages, in 330 instances 
no information could be obtained. Of the remainder, 
in 383 cases, including 296 males and 97 females, replies 
were obtained showing that insanity was directly due to 



120 SHALL WE DRINK WINE? 

alcoholic excess. In 1,123 cases, including 479 males 
and 644 females, the insanity was said not to be due to 
excessive alcohol consumption. Therefore, expressed in 
percentages, the point as to whether the lunatic was made 
insane by alcoholic poisoning was not ascertained in 17.97 
per cent of the cases; insanity zvas the result of alcoholic 
poisoning in 20.86 per cent, of the cases, and it was not 
the result in 61.77 per cent, of the cases. 

Going into the question as to whether the intemperate 
habits of one or both parents led to the insanity of the 
lunatic, produced the following results: In 1895 cases no 
information could be obtained., in 20 cases the reply was 
"yes/' and in 921 cases the reply was "no," that is, no 
information could be obtained in 48.75 per cent, of the 
cases, the negative replies were 50.16 per cent., and the 
affirmative replies 1.09 per cent, of the whole number, 6 
of which were males and 14 females. In 184 cases 
insanity was attributed to intemperate habits in the grand- 
parents, in 170 cases the grandparents were said to be 
temperate, and in the remainder of the cases, 1,482, no 
information regarding the habits of the grandparents in 
this respect could be ascertained. 

This question was also asked: "Did the intemperate 
habits of others (neither parents nor grandparents) lead 
to the insanity of the person considered?" In 123 cases 
the reply was "yes," in 757 it was "no," and in 956 cases 
no information could be elicited. 

Analyzing the above statistics, it will be seen that of 
the whole number of insane patients whose habits could 
be learned 35.48 per cent, of the males and 10.02 per 
cent, of the females were excessive drinkers. But exces- 
sive drinking might not have been the cause of the insan- 
ity, it might rather be the result of some neurosis. Fur- 
ther on, however, we learn that out of a total of 1,506 



ALCOHOL IN THE PRODUCTION OF INSANITY. 121 

cases alcohol was held to be the direct cause of the insan- 
ity in 383 cases, 296 of which were males and 87 females. 
As had already been stated, the habits of only 699 males 
as to their indulgence in alcohol could be learned, and 
296 attributed their insanity to alcohol directly. Thus we 
have 42.5 per cent, of all the males whose habits in this 
respect could be ascertained made insane by alcoholic 
poisoning. Of the 649 females whose habits in this respect 
are known only 87, or 10.86 per cent., were made insane 
by direct alcoholic poisoning. 

Of the evidence which these statistics contain, that 
relating to heredity shows that 1.09 per cent, of those 
from whom information on the point could be obtained 
attributed their insanity to parental intemperance, and 
123, or 6 per cent, of all concerning whom grandparental 
influence could be ascertained attributed their insanity to 
that cause. 

Taking for granted that the cases concerning which 
the direct or ancestral influence of alcohol could not be 
ascertained would show the same percentages as those in 
which it was ascertained, we would have a total of prob- 
ably about 45 per cent, of all the cases of insanity in this 
group chargeable either directly or indirectly to alcohol. 
This method of drawing conclusions, however, should 
not be permitted. 

A further fault of the above statistics is the fact that 
many of the cases may have been influenced in several 
ways by alcohol, directly, through parental or grand- 
parental or collateral relatives' intemperance. All such 
cases would be counted in each class, and be considered 
as not one insane patient but as many as there are classes. 
Statistics of this kind are not valuable. 

Insanity statistics in the United States are not reliable. 
The census report for 1880, for instance, showed the fol- 



122 SHALL WE DRINK WINE? 

lowing number of insane person for every 100,000 inhab- 
itants: Foreign white 398.8, native white 161.9, and 
negroes 91.2 respectively, while the census report for 
1890 showed 387.0 foreign white, 140.5 native white, and 
88.6 colored insane to each 100,000 inhabitants. The 
total number of insane reported for 1880 was 91,959, while 
the total number of insane reported in the census returns 
of 1890 was 106,485, showing that in the decade the 
number of insane persons increased a trifle more than 
15 per cent. But the population increased 24 per cent, 
in the same time. In 1896, however, the National Con- 
ference of Charities and Corrections reported 145,000 
insane persons in the United States, an increase of nearly 
37 per cent, in six years. The only conclusion to be 
drawn is that the statistics of the United States census 
reports are of no value in showing whether insanity has 
increased or decreased. It is generally believed, how- 
ever, that insanity is increasing, and this increase is shown 
in statistics for localities. Whether insanity is increas- 
ing in the same ratio as the per capita consumption of 
alcohol we have no means of knowing. 

Something more definite regarding this matter has 
been obtained in Europe. In the German Empire alone 
in 1877 there were 4,272 patients undergoing treatment 
for alcoholic insanity in public institutions. In 1885 this 
number has increased to 10,360, an increase out of all 
proportion to the increase in population (Die Gefahren 
des Alkoholgenusses, Dr. Servus). 

According to the statistics of Baer there were, in the 
years 1878 and 1879, 4> OI 3 ma l e lunatics in the Ger- 
man insane asylums, the insanity of 1,088, or 2.J per cent., 
of whom could be traced directly to the influence of alco- 
hol. Of these 690 suffered with delirium tremens. If 
we reckon with these the patients who were treated in 



ALCOHOL IN THE PRODUCTION OF INSANITY. 123 

private institutions, the total of alcoholic insane amounts 
to 2,016 yearly. Furthermore, in the years 1878 and 
1879, tne yearly number of patients suffering from the 
extremest forms of alcoholic disease in institutions the 
statistics of which were open to inspection, amounted to 
5,212. In those years there died from alcoholic poison- 
ing 1,993 persons yearly. In the year 1885 there were 
11,974 such patients in Germany, with a correspondingly 
high mortality. Considering, again, the Swiss statistics, 
it was found that of the 366 deaths from alcohol occurring 
in 1 89 1, 187 belonged to the laboring classes, and 179 
were men in the easier circumstances of life. 

Of special interest is the fact that the increase in the 
number of lunatics in the asylums of Germany was very 
rapid after the middle of the present century, at which 
time the manufacture of whisky from potatoes was begun. 
In France also were the effects of this new industry very 
apparent. In the Bicetre, according to Baer, from 1806 
to 181 1, the number of male lunatics whose insanity could 
be ascribed to alcohol was only 11.7 per cent, of the 
whole number. In 1855 it had slightly increased, but 
still was only 12.78 per cent., but in 1865 it had increased 
to the astonishing figure of 25.24 per cent, of the whole 
number. 

In Charanton the proportion of alcoholic lunatics from 
1826 to 1835, according to Esquirol, was 8 per cent; Lage- 
rose estimated the proportion at 24 per cent, in 1857, and 
by Marsaing it was estimated to average 27.87 per cent, 
during 1865 and 1870. 

In Austria, according to the best of evidence, since 
the beginning of the fiftieth year of this century there has 
been an average yearly increase of 2 per cent, in cases 
of insanity, and these increasing recruits are said by Gaus- 
ter to come exclusively from the ranks of alcohol drink- 



124 SHALL WE DRINK WINE? 

ers. What this increase means will be better understood 
when it is known that every ten years a new asylum cap- 
able of accommodating 600 patients must be erected, and 
that 2,000 more apply each year for treatment than applied 
forty years ago. At the time when this report was ob- 
tained about 40 per cent, of all the cases of insanity affect- 
ing males could be ascribed to alcoholic excesses. 

Recent statistics upon this point in Germany are not 
accessible. The last obtainable showed that 27 per cent, 
of the male and 3.2 per cent, of the female lunacy patients 
became such through excessive alcohol consumption. In 
institutions which lie near large centers of population the 
percentage of alcoholic insane is considerably greater. 
Statistics from Prussia especially show a rapid increase 
in the number of insane. In 1852 to 1854 there were 
only 3,631, but the number had increased to 8,481 in 
1870 to 1872, an increase out of all proportion to the 
increase in population. 

"In another place I have already stated what seems to 
me of the utmost importance, that we in Germany are so uni- 
versally accustomed to look upon alcoholism as the normal 
condition, the basis, in a certain degree, of the normal phys- 
iological man, that our physicians need the strongest kind 
of hint (with many, even an attack of delirium tremens is 
not sufficient) to lead them to the thought that the illness is 
the result of chronic alcohol poisoning" (Dr. August Smith, 
Die Alkoholfrage, P. 74).* 

*"In anderem Orte, habe Ich erwaehnt, was mir zu 
wiederholen wichtig scheint, das wir in Deutschland im 
allgemeinen so sehr gewoehnt sind, den chronischen Alko- 
holismus als Normalzustand, die Grundlage gewisser- 
massen des physiologischen Menschen anzusehen, das es 
bei unseren Aerzten schon der aller kraeftigsten Hin- 
weise bedarf (ein Delirium Tremens genugt manchen dazu 



ALCOHOL IN THE PRODUCTION OF INSANITY. 125 

noch nicht) um bei einer Erkrankung nur den Gedanken 
einer Alkoholvergiftung aufkommen zu lassen." 

Some significant statistics came from the Dalldorf 
Asylum (Mansfield Holmes in Medical Pioneer, Aug., 
i895), where, out of a total of 1,234 patients confined, 450 
were children. Rust, the physician in charge of the 
asylum, considered the large percentage of insane children 
due to the fact that habitual drinking was the rule and 
not the exception. Investigations by the local authorities 
show that alcohol may produce insanity by acting as an 
exciting cause, or it might produce ah hereditary insanity 
by transmitted debasement in children in the form of pre- 
disposition. Rust thinks periodical excessive drinking 
more likely to produce insanity in the subject himself, 
but that habitual constant drinking is more apt to breed 
hereditary insanity in the offspring, and that bad heredity 
as a determining cause of insanity played a most important 
part with the patients in this institution. H. Piper, one 
of its physicians, stated that up to 1882, at which time he 
began his observations, the total number of reliable cases 
then collected in the German statistics was 1,287; of this 
number 860, or 66 per cent., were traced to hereditary 
causes and the balance, 427, or 33 per cent., to acquired 
causes. This is a proportion of two cases of heredity to 
one of acquirement. Of 416 cases collected by himself 
during the twelve years following 1882, 310, or 75 per 
cent., were traced directly to hereditary causes, and 25 
per cent, to acquired causes : a ratio in favor of hereditary 
causes of three to one. 

Undoubtedly, however, many cases of insanity due to 
alcoholism are the result of children of tender years ingest- 
ing large quantities of alcoholic liquors, rather than to 
inherited tendencies alone. I have seen in the city oi 
Berlin children from five years of age upwards given free 



126 SHALL WE DRINK WINE ? 

quantities of strong wine and beer, the effects of which 
must have been seriously deleterious; and Moreaux oi 
Tours, France (Annales Medico-psychologiques), con- 
siders alcoholism, so prevalent in children, only partly due 
to hereditary influence. Drunkenness in these cases is 
sometimes seen at a very early age, and when there is a 
hereditary predisposition a small amount of alcohol is 
sufficient to produce intoxication. He found in alcoholic 
children marked evidence of evil dispositions leading to 
criminal tendencies. The continental custom of giving 
young children wine is a powerful factor in bringing about 
this state of affairs, while some responsibility rests with 
the indiscriminate prescribing of alcoholic medicines b) 
physicians. He had seen delirium tremens in children 
four or five years of age, brought about, as in adult life, 
by the sudden stopping of alcohol with children who were 
habitual drinkers. 

More recently Jakubowitsch (British Medical Journal) 
reported increasing drunkenness among the children of 
Russia, where vodka, an acrid drink containing from 40 
to 50 per cent, of alcohol, is the national beverage. He 
also tells of children four or five years of age having had 
delirium tremens. Parents there, he says, often thought- 
lessly give their children spirituous liquors to improve the 
color of their cheeks, make their eyes sparkle, or induce 
sleep. He also discusses the influence of alcoholism in 
the parents in producing hereditary defects in the children, 
and cites cases similar to those already given in another 
part of this work in which children begotten while the 
parents were sober were healthy and intelligent, while 
others conceived when the same parents were intoxicated 
showed marked cases of physical and mental degenera- 
tion. Among the least progressive peoples of France, 
especially those of Brittany, children are, at a very tender 



ALCOHOL IN THE PRODUCTION OF INSANITY. 127 

age, habituated to the daily use of spirits. In Great 
Britain and in our own country, though in a less degree, 
in large centers of crowded and vicious population the 
use of drink among children of a tender age prevails to 
an alarming extent, and the consequent physical defective- 
ness and moral degradation lead to habits of viciousness 
and immorality shocking in the last degree. 

It would be no easy task, therefore, in cases of insanity 
among children due to alcoholism to determine how much 
of the disturbance may be due to the direct effect of 
alcohol and how much to hereditary effects where both, 
as is very frequently the case, operate as determining 
causes. 



XIL 

JZhc Httitude of the Medical profession toward 
Hlcobol. 

About the value of alcoholic beverages in the normal 
condition of health there is only one medical opinion, and 
that is that they are entirely unnecessary and therefore 
do no good. In America at least a small number of 
physicians would probably express the opinion that "mod- 
erate drinking is not harmful/' perhaps the same number 
would hold that any amount of alcohol in health is harm- 
ful, while the great majority are probably influenced by 
their surroundings and have no fixed opinions upon the 
subject. 

As to the value of alcohol in disease, medical opinion 
is again divided. There are many physicians, and the 
number is growing, who believe that while alcohol has 
some value in diseased conditions this value is very limited, 
and that it performs no duties as a curative agent which 
could not be better and more safely performed by some 
other agent. A much larger number, however, especially 
those who were educated on the continent of Europe, still 
cling to the traditions of medical practice and prescribe 
alcoholic beverages in various diseased conditions, espe- 
cially such as indicated a lowered vitality, lack of appetite 
and strength. I say this is done as a matter of routine prac- 
tice, for I believe that the majority of physicians who do 
this have not given the subject any particular attention, but 
are bound by the authority of precedent. Among men 



THE ATTITUDE OF THE MEDICAL PROFESSION. 129 

who have to deal with nervous diseases and with insanity, 
at least here in America, alcohol as a therapeutic agent 
has no place. 

Certainly no other remedy for the treatment of disease 
has been as extensively used as alcohol in the form of 
some alcoholic beverage. Its use received a great impetus 
about the end of the eighteenth century in England from 
the teachings of that time, which would see the causes 
of all diseases in a condition of "sthenia," or "asthenia," 
according to whether the surface play indicated increased 
activity of the heart and "plethora" or the lack of them. 
For the former bleeding, emesis, and catharsis were the 
prime remedies, while for the latter nothing found so 
much favor as alcohol. 

The first half of the present century was completely 
under the influence of those teachings. Todd and his 
pupils treated all inflammatory diseases, especially typhoid 
fever, with enormous quantities of alcoholic liquor. It 
was not an unusual thing at this time for a patient ill with 
typhoid fever to receive two or three bottles of strong 
red wine, port, or burgundy, besides a considerable quan- 
tity of champagne and cognac, as much as a quart of 
the latter often being given within the course of twenty- 
four hours. 

Todd and his school were followed by the greatest 
lights of the profession in both Europe and America. 
Trousseau, Moneret, and Terrier in France advised a 
free administration of alcohol in typhoid fever. Soulie 
treated all his cases of typhoid, whether mild or severe, 
with rum in doses of 60 to 80 grams (Bullet, de Thera- 
peutique, 1870), and Bouvier was conspicuous in his 
advocacy of the administration of strong wines in typhoid 
fever. In Germany Liebermeister, Riegel, and Juergen- 
sen used large quantities of alcohol in treating typhoid 



130 SHALL WE DRINK WINE? 

fever and the so-called "asthenic" inflammations of the 
lungs. Daret and Breisky gave the same treatment for 
puerperal fever; Leyden, for gangrene of the lung, and 
Volk, for the treatment of erysipelas. It was held by all 
of these eminent men that alcohol within proper bounds 
and where there was no definite contraindication was of 
the utmost importance in relieving the prostration incident 
to all of those exhausting diseases, and that during the 
course of the fevers alcohol would not intoxicate. 

European medical opinion was very naturally reflected 
in America. Here medical writers of twenty-five years 
ago, or even of a more recent date, almost uniformly 
advised the administration of alcohol in all inflammatory 
diseases attended by great exhaustion. There were some 
prominent dissenters from the generally accepted creed, 
but they were few in number compared with those who 
clung to alcohol as a stimulant. Indeed, within the past 
few years, if a physician were advised to "stimulate" his 
patient he would take that advice to mean that his patient 
should receive alcohol in the form of strong spirits. 
Recent developments in chemistry and biology, especially 
in the chemistry and biology of bacterial diseases, are 
forcibly bringing to the notice of the profession the errors 
of past teachings as to the stimulating value of alcohol. 

There are a few medical men who openly espouse the 
cause of alcohol, not only as a valuable remedy in disease, 
but as having increased the sum total of human happiness. 
Some of these men have given reasons for the faith that 
is in them, while others have been content to merely 
express their opinions. The number of these men, how- 
ever, is small compared with those who hold opposing 
views. It will be instructive to examine the views thus 
set forth in order to learn the evidence upon which they 
rest. 



THE ATTITUDE OF THE MEDICAL PROFESSION. 131 

Mortimer Granville has said: "Drunkenness is in no 
other sense the consequence of drinking than the destruc- 
tion of a house by fire is the consequence of having a 
cooking range on the premises. The moment appears 
opportune for a little plain speaking and I trust that this 
may be permitted in one of those who seeks to convert 
the public mind — that alcohol in all its forms is needless 
to the healthy and only of questionable value to the sick — 
to those who hold that it is far better that the healthy 
should be moderate drinkers than abstainers, and that the 
great value of alcohol in the treatment, and I will go 
farther and say, in the prevention of disease, should be 
clearly recognized. I am perfectly well aware that in 
professing this strong belief that abstinence from the use 
of wine or beer is a worse evil than occasional abuse of 
these intoxicants — I use this form of expression advisedly 
— I am placing myself in antagonism to the majority of 
medical writers on this subject, but I am so thoroughly 
convinced of the accuracy of this view after years of 
study and observation of the subject, in its professional 
and social aspects, that I should be lacking in moral 
courage if I hesitated to express myself decidedly. I 
sincerely believe that incalculable harm has been done 
to the human organism with its functions, which we are 
wont to classify as mental and physical, by the spread of 
teetotal views and practices. There is less stamina in the 
life of the average Englishman now than there was fifty 
years ago. He may live a little longer, but he is not so 
well able to resist the invading germs of disease, or to 
recover from the depleting effects of such invasion, as he 
was when good wine and sound ale was an integral part 
of his daily diet. He has lost some, if not much, of the 
practical advantage due to the diminution of preventable 
maladies by improved sanitation, because he has allowed 



132 SHALL WE DRINK WINE? 

his organic life to fall to a grade lower in vital energy 
than that which previously protected him against perils 
greater than those that now beset him. Asylum physicians 
go their rounds and notice that a very large proportion of 
those who became insane previously drank to excess; but 
if the bulk of the general practitioners outside of the 
asylums were asked what proportion of those who 
habitually drank became insane — which is a very different 
matter — the evidence that drink plays an important part 
in the production of insanity would be found to fall to 
the ground. I doubt whether, of the great bulk of general 
practitioners who have the opportunity of collecting infor- 
mation upon this subject, any large number could com- 
pile twenty cases falling under their individual observation 
of persons who habitually drank freely and became insane. 
It is needless to the point to tell us that of insane persons 
many once drank. We want to know the proportion of 
persons who drink that is passing into the class of lunatics. 
So far as I have been able to ascertain, this portion is so 
small as to be insignificant. Meanwhile, a calm and 
grave survey of the statistical and facts will show that not 
a few terrible diseases, such as consumption, cancer, 
specific maladies of low type — for example, diphtheria, the 
worst forms of gout, nervous troubles, and a host of minor 
ailments — have for their cause asthenic conditions of vital 
force in the organism which render it, as a whole, weak 
in the presence of its enemies, and, as to its constituent 
parts, prone to the degradation of organic types of life, 
and have developed and extended their ravages since the 
substitution of table waters for the sound (malt and hop 
and grape) fermented beverages has sprung into fashion 
at the instance of temperance advocates. These are grave 
assertions to make, and I am not insensible to the respons- 
ibility which attaches to the physician daring to make 



THE ATTITUDE OF THE MEDICAL PROFESSION. 133 

them; but I am persuaded that the time has come when 
those who do not share the views it is fashionable to 
profess ought to declare themselves." 

It is not necessary to point out the many errors in 
the views of the above writer. Here are a group of bold 
assertions without any evidence to support them, except 
the casual observations of the writer, not one of which 
but is abundantly refuted by exact methods of observa- 
tion and investigation, the results of which have already 
been fully set forth in this work. 

When the attention of the great Charcot was called 
to Tolstoi's article on alcoholism, he replied (British 
Medical Journal, July, 1891): "I am compelled to admit 
that I do not find the article of Tolstoi very able. It is 
exaggerated, and, therefore, false. Alcohol and tobacco 
are injurious, but they can be used in moderation. There 
are numerous examples of this. Moreover, before alcohol 
and tobacco there came into the world abominable things. 
Indeed, since their introduction civilization has rather 
softened. Must one say, then, that alcohol and tobacco 
are immoral forces? In everything I hate extreme posi- 
tions. I believe in common sense, and I do not see that 
the position of Tolstoi conforms to its dictates." 

There is always a disposition to attach importance to 
the opinions of great men without regard to the basis 
upon which they are founded. The mere fact that some 
one in authority has promulgated the opinion is sufficient 
to give it weight without regard to its intrinsic value. 
Because "civilization has softened" (if there was any 
civilization before the introduction of alcoholic beverages) 
since the introduction of alcohol and tobacco, how does 
that prove the value of these narcotics unless they can 
be connected as cause and effect? Such methods of 
reasoning are childish. 



134 SHALL WE DRINK WINE? 

Another example of this specious mode of reasoning 
is found in an article by Dr. S. S. Herrick (Journal of the 
Am. Med. Assn., Feb. 19, 1898): "This alleged de- 
generacy has been going on ever since Noah planted the 
vine and got drunk on its products, on coming out of the 
ark, yet within the period of profane history the span of 
human life has doubled and is increasing. France, Spain, 
and Italy are producing annually, according to different 
estimates, fifteen to forty gallons of wine per capita, most 
of which is consumed at home, and this has continued 
for centuries; the output of wine and beer in Austro- 
Hungary is about fifteen gallons annually per capita, and 
in the German Empire double this amount. On the alco- 
holic basis, degeneracy in the latter progresses twice as 
fast as in the former. In these European countries chil- 
dren drink fermented liquors from the time they are 
weaned, and follow the habit all their lives. Inasmuch as 
human life is steadily lengthening, popular education ex- 
tending, and military power growing, the present writer 
fails to see proofs of degeneracy." 

Arguments of this kind will convince no logical mind. 
Why did not Dr. Herrick use his own statistics to draw 
another conclusion? He has said that the consumption 
of wine, per capita, in France, Spain, and Italy is nearly 
three times that of Austro-Hungary, and one and a half 
times that of the German Empire: therefore, should we 
not look for a greater amount of degeneracy in the Latin 
countries than in either Austria or Germany? If this 
writer really believes in his own method of reasoning, he 
should have reached the conclusion that the degeneracy 
of France, Spain, and Italy, recognized by all intelligent 
people, is really due to their excessive use of alcoholic 
beverages. He should not have been content to point 
out that Germany is no more degenerate than Austro- 



THE ATTITUDE OF THE MEDICAL PROFESSION. 135 

Hungary, though the former does consume twice as much 
alcoholic liquor as the latter. As to his statement that 
the children of these countries "drink fermented liquors 
from the time they are weaned and follow the habit all 
their lives," enough has already been said of the deplor- 
able results of this reprehensible habit, yet the statement 
is made by this writer to carry the impression that no 
evil results follow. If he fails to see proofs of degeneracy 
it must be from the fact that he has not examined the 
evidence. It is absurd to take a few general facts, ignore 
the rest, and then draw sweeping conclusions. I cannot 
leave this article of Dr. Herrick's without calling attention 
to another example of his most fallacious reasoning. He 
calls attention to the fact that "the native populations of 
Old and New Mexico, having been subjected to small- 
pox with little or no modification by vaccination for three 
and a half centuries, have acquired a great tolerance" 
and that "the races of tropical America have become 
tolerant of yellow fever that total immunity is claimed for 
them by some writers," therefore, we must conclude, peo- 
ple long accustomed to alcohol and other narcotics will 
also get a degree of immunity which will make alcohol 
harmless. But alcohol does not and cannot give such 
immunity. It is so different in its nature from the poisons 
of small-pox and yellow fever, so different in the biochemic 
changes which it produces in the body, that any attempt 
to compare the two indicates an absurd lack of knowledge 
of immunity processes. 

In a comprehensive work on dietetics (Practical 
Dietetics, W. Gilman Thompson, M. D., 1896,) the sub- 
ject of alcohol is treated at considerable length. The 
author excuses a full presentation of the subject upon 
the plea that it would be too long for the limits of his 
book, hence we do not know upon what evidence he bases 



136 SHALL WE DRINK WINE? 

his conclusions, which are as follows: "The problem 
whether the world as a whole is better or worse for the 
existence of alcohol, aside from all ethical questions, and 
viewed merely from a scientific standpoint of the influence 
of alcohol upon mortality, is difficult of solution; for, to 
offset the numerous cases of fatal alcoholism and still 
larger number of cases of diseases which would not 
presumably be fatal without the existing condition of 
chronic alcoholic poisoning of the system, are very many 
cases among both infants and adults in which life is un- 
doubtedly saved by the prompt resort to this food and 
stimulant and its energetic use. So long as man is 
exposed to hardships and conditions arising from im- 
proper and deficient food supply, as well as the numerous 
infectious diseases to which he is heir, alcohol must still 
be regarded as a blessing rather .than a curse; for there 
is no form of stimulant and food combined, or stimulant 
alone, which, taken all in all, can be so completely relied 
upon in cases of emergency. Alcohol when taken alone 
will prolong life beyond the period at which it terminates 
from starvation." 

From the above conclusions one who has knowledge 
of all the evidence must wholly dissent. They are in direct 
opposition to the great mass of experimental truths which 
have resulted from the most laborious, painstaking, and 
exact methods known to science, and which have been fully 
discussed in this work. There can be no hesitancy in 
making a choice between the loose generalizations and 
guesses founded upon unsupported statements, and the 
knowledge actually gained by experimental research. 

There is still another class of physicians who for 
clinical reasons alone have discarded alcohol as a thera- 
peutic agent. These are busy, practical men, good 
observers and quick to take advantage of any remedy, 



THE ATTITUDE OF THE MEDICAL PROFESSION. 137 

the value of which is apparent, without taking the time 
to inquire very closely into the reasons for the good 
results exhibited. These men, I find, are almost a unit 
against the giving of alcohol in diseased conditions except- 
ing where the patient happens to be an alcoholic habitue 
and its. withdrawal would be attended by serious nervous 
disturbances. 

One physician of this class, who has enjoyed a large 
general practice for more than twenty-five years, in 
answer to my question, declared that he had not prescribed 
an alcoholic beverage for more than ten years, and his 
reason was that he had never observed any good to 
result therefrom. A surgeon who is a teacher of anatomy, 
and who also is surgeon of a railway company, in which 
capacity he has to deal with many acute injuries attended 
by pain, loss of blood, and shock, answered the same ques- 
tion by saying that he not only did not use alcohol in 
dealing with these cases, but neglected no occasion to 
caution the railway employes against taking spirits in case 
of their own injury or giving it to their fellows under the 
same conditions. His observations had led him to believe 
that nervous disturbances were prolonged and intensified 
in those cases in which alcohol had been freely given, 
which was often done before he could reach the patient. 
A physician of ripe age and many years experience with 
hundreds of old men in a Soldiers' National Home said 
that alcohol is the worst enemy of the veterans under his 
charge. Not only do the majority of fatal issues resulting 
from some inflammatory diseases take place immediately 
after an alcoholic excess, but he has seen no diseased con- 
dition improve under the administration of spirits in either 
small or large quantities. The men who totally abstain 
are better nourished, freer from disease, and carry their 
years more lightly than those who take alcohol in any 






138 SHALL WE DRINK WINE ? 

quantity. Many of the inmates are alcoholic inebriates. 
They demand their accustomed drink and get it. It is 
possible that some of these would die sooner if it were 
suddenly withdrawn, therefore, in these cases, alcohol 
probably prolongs life. Nearly all of this class have 
organic diseases directly traceable to the long continued 
use of alcohol. 



XIIL 
(Hbo Become Drunkards and Why} 

That the great majority of drunkards become such 
through the influence of social environment cannot for a 
moment be doubted. To drink and ask the companion- 
ship of others in drinking alcoholic beverages is the first 
lesson in the primary school that develops the confirmed 
drunkard, and to drink and ask others to drink is and 
always has been so much an integral part of social func- 
tions of a large part of our people that time and observance 
have elected them to the position of at least quasi-social 
duties. The ease with which intoxicating drinks may be 
obtained wherever there is any considerable aggregation 
of people makes the practice of this social custom quite 
universal. It would be absurd to deny that the social 
status of indulgence in alcoholic beverages does more to 
make drunkards than all the other causes combined, for 
the sanest of individuals, beginning to drink through the 
influences of social environment, may become as hopeless 
a drunkard as any defective member of society. So subtle 
are the processes of the narcotics, of which alcohol is one, 
in creating a need on the part of the nervous system for 
a repetition of the same drug, that the habitue becomes 
such before he is aware; and his chance to regain his 
former mental and physical condition, other things being- 
equal, is in exact ratio to the amount of damage he has 
sustained from alcoholic poisoning. 

To show how great is the influence of social drinking 



140 SHALL WE DRINK WINE ? 

in the production of drunkards one has only to recall the 
fact that the vast majority of drunkards are of the male 
sex. Here in America, where the drinking of alcoholic 
intoxicants does not prevail among the women as a whole, 
the ratio of male to female drunkards is certainly as great 
as one hundred to one, and probably much greater. 
Assuming that heredity is as influential in producing 
female as male alcoholic degenerates, which, according 
to laws of heredity, must be true, the preponderance of 
male drunkards over those of the female sex must be 
attributed to the increased opportunity for alcoholic in- 
dulgence enjoyed by the male. Nor can there be any 
reasonable doubt that many male defectives, the victims 
of a neuropathic heritage from alcoholism or any other 
parental cause, would become useful and reasonably happy 
members of society could their enforced abstinence from 
alcohol be assured, but these are almost always the un- 
fortunate victims of social drinking. The pleasing effects 
of alcoholic narcotism once experienced, the habit of alco- 
holic excess is soon formed; and the will power, always 
insufficient, is still further weakened until resistance is 
no longer possible and the degenerate abandons himself 
to the bestiality of satisfying his vicious appetite. 



XIV. 
Olbat Is Inebriety? 

The term inebriety is rather loosely used, both by the 
profession and by the laity. In its simple and broader 
sense it means no more than habitual intoxication. 
Formerly it meant merely the condition of drunkenness; 
now it is by common consent applied to those cases which 
exhibit an overmastering appetite for narcotics in quantity 
sufficient to intoxicate, together with the gratification of 
that appetite. When unqualified, alcoholic inebriety is 
understood. Dr. Norman Kerr has suggested that 
"inebriety" be displaced by the term "narcomania/' which 
he defines as "a mania for intoxication by an intoxicant." 
This gives the term a new aspect, for, according to this 
definition, a narcomaniac would be an inebriate whether 
he indulged his abnormal appetite or not. 

Inebriety is called a disease, and the term is modified 
to suit the special narcotic for which the subject evinces 
an abnormal appetite. There may, from this point of 
view, be as many forms of inebriety as there are narcotic 
drugs capable of producing their forms of intoxication. 
There is a general belief, upon the part of the laity at least, 
that the inebriate appetite is selective from the beginning, 
that certain individuals evince an overmastering desire 
for certain narcotic drugs and that they will be satisfied 
each only by a particular narcotic. Especially does this 
view prevail with the public as to alcoholic inebriety, and 
certain influences which will be discussed later have done 
much to spread and confirm this view. 



142 SHALL WE DRINK WINE? 

In former times drunkenness was considered as always 
a voluntary and vicious act, and punishment was meted 
out of various degrees of severity, from fines and imprison- 
ment to whipping, torture, and death. Indeed, a visit 
to a police court in any of our larger municipalities on 
any of the working days of the year will convince the 
observer that, though the whipping post, the pillory, and 
the scaffold have been abolished nothing better than fine 
and imprisonment has yet been discovered as a corrective 
for public drunkenness. In more recent years, as a result 
of medical investigation, there has grown up a belief that 
the drunkard is not always responsible for his acts, that 
he may be physically and mentally defective, and that he 
should be treated, not as an offender against the law, but 
as a sick man who is afflicted with a species of insanity. 
The public, or at least that part of the public philan- 
thropically inclined, has seized this idea; but, not pos- 
sessing that discriminating power which is possessed by 
medical men, have come to regard all drunkards as 
afflicted with that disease called inebriety, and to think 
that "its victims are irresponsible." This idea is erroneous 
and mischievous, but it has been so persistently fostered 
and so widely disseminated by certain commercial institu- 
tions that its teachings have had an enormous effect. It 
is not sufficient to say that medical men know that this 
teaching is false. The mehods adopted by these institu- 
tions have made it the most prominent factor in the 
alcohol question in America during the past eight or ten 
years, and its influence has been many times that of 
thoughtful medical men who have stood for the truth. 
These institutions teach that inebriety is a specific disease. 
We need not discuss the purposes for which they do so, 
when we call attention to the fact that a specific cure is 
offered to all who can afford to pay the price. Neither 



WHAT IS INEBRIETY? 143 

is it necessary to call attention to the various sophistries 
set forth by its supporters to bolster up this syndicated 
opinion, for the purpose of refuting them. We must not 
forget, however, in our practical dealings with the alcohol 
question that the "literary" machinery of this venal institu- 
tion has probably converted a majority of the laity to its 
views. 

The statement that inebriety is a disease should not 
be taken without qualifications. It is generic rather than 
specific. It is no more a disease than nervousness or 
dropsy. It is a morbid condition of the nervous sys- 
tem which craves the intoxicating effects of narcotics. 
This craving may arise from degenerate conditions result- 
ing directly from the action of the narcotic upon the 
subject himself, it may come to him as a congenial 
fault, or it may be the outgrowth of nervous dis- 
turbances coming on at any time of life from any cause. 
In short, anything which makes existence continuously 
painful tends to produce inebriety by driving the victim 
to such means as may be most easily available to find 
relief. There are many examples of a selective appetite 
manifested in early life, a preference exhibited for a par- 
ticular form of narcotic, but this appetite very rarely or 
never becomes evident until the subject has actually 
experienced the intoxicating effects of the drug of his 
choice. To show that this is true one has only to recall 
that alcoholic inebriety very largely preponderates over 
all other kinds, and that the number of male inebriates 
is very much in excess of the female. This is due to the 
fact that the habit of drinking and treating prevails almost 
exclusively among males, thus giving every oppor- 
tunity of arousing any latent defect, or, rather, of sug- 
gesting that alcohol be drunk because it is seen to 
contribute to the apparent wellbeing of the drinker, who 



144 SHALL WE DRINK WINE? 

may be the victim of a latent defect. On the other hand, 
such occasion for bringing out latent defects does not 
often come to the female. If they exist they are more 
likely to be disclosed by the physician's prescription. For 
this reason, while as alcoholic inebriety among women 
of respectable standing and habits is very rare, other drug 
addiction is much more common. Morphine, chloral, 
bromides, and, more rarely, cocaine habitues are in my 
experience much more common among the latter than 
among the former, and their inherent morbidity was 
almost always aroused, in the first instance, by something 
prescribed by the family physician. There can scarcely 
be any doubt that opium inebriety would be the most 
common form prevailing if preparations of opium pleasing 
to the taste were sold under the same conditions which 
now regulate the sale of alcoholic beverages. 

It should be understood, then, that inebriety instead 
of being a specific disease which always drives its victim 
to some form of narcotic excess is simply a defect in his 
nervous organization which makes his condition, his ex- 
istence, under the influence of some narcotic intoxication 
more pleasurable or less painful than during abstinence. 

Inebriety arising from nervous defects presents many 
variations of type and widely differing degrees both of 
nervous disturbances and excesses in alcoholic indulgence. 
It may be periodical or continuous. 



XV. 

Intermittent or periodical Inebriety. 

Men, especially young men, who are occasional 
drinkers sometimes drink to excess. It would be difficult 
to find one of this class who has not at least once felt the 
intoxicating effects of alcohol. To some a single ex- 
perience of the painful after effects of alcoholic poisoning 
is sufficient to prevent a repeated indulgence, but the 
number is not large. Here again social influences pre- 
dominate to make the occasional drunkard. There is 
an undefined, and generally unspoken sentiment, among 
boys and young men that a physical tolerance for alcohol 
is an evidence of mature manhood; and, therefore, that 
he who is able to drink the greatest amount of the 
intoxicant at hand without showing signs of complete 
intoxication is deserving of respect. To have a "weak 
head" for wine is to invite derision and reproach. In 
stories of England's country gentlemen, they have been 
described as "two bottle," "four bottle," or some other 
number of bottles, men, meaning that they habitually 
drank that number of bottles of wine, generally port wine, 
after dinner, and to be a "twelve bottle man" was to excite 
no little admiration in the rural community. Similarly 
on the continent of Europe, and especially in Germany, 
is this sort of manly superiority recognized at the present 
day. There, as is well known, the students of various 
universities have their beer drinking contests for the pur- 
pose of electing a "beer king," the last man or boy to "fall 



146 SHALL WE DRINK WINE? 

under the table" from sheer acute alcoholic poisoning 
being unanimously chosen to wear the royal ermine of 
King Gambrinus. 

The idea that social superiority attaches to an ability 
to drink large quantities of alcoholic beverage exists in 
a still more marked degree with the lower orders of society, 
while a "weak head" is assailed with a deeper measure 
of contempt. I have heard many stories of this sort of 
prowess among the lumbermen of the north, mill hands, 
and lake sailors, while I have seen poor wealdings intoxi- 
cated with whisky furnished by their more accomplished 
fellows in order to be made the butt of rough ridicule. I 
have known a periodic drunkard to drain an ordinary table 
tumbler full of raw whisky at a single draught before 
sitting down to his breakfast, turn to a companion, and 
say, "Ah, Joe, me boy you will be a dandy when you can 
do that!" and I have known of a "boss" in a lumber camp 
who refused to hire a man because "he could stand so 
little whisky." 

The influence of this sort of public opinion in the 
production of inebriety cannot be overlooked. Not only 
is it calculated to rouse all the latent desire for narcotic 
intoxication, but it may drive the novice, even though it 
cost him several painful experiences, as is the case in 
acquiring the tobacco habit, to acquire not only a taste, 
but an imperative need, on the part of his abused and 
degenerated nervous system, for alcoholic narcotism. 

There may, therefore, be many occasional or periodical 
drunkards whose excesses are caused by certain determin- 
ing influences without the existence of any inherent defect. 
To apply the term inebriate to these would be to confuse 
the subject. They are, as far as may be ascertained by 
any method of examination, mentally and physically sound 
before and after their alcoholic excesses. 



INTERMITTENT OR PERIODICAL INEBRIETY. 147 

A smaller number of periodical drunkards are true 
degenerates. Without apparent external cause, in the face 
of promises and protests to the contrary, against the 
prayers of those who have the greatest influence over him, 
and in the face of impending business ruin and personal 
disgrace, alcoholic excesses are begun and continued until 
the storm has exhausted itself in a debauch. Then comes 
a period of deep remorse sometimes leading to suicide. 
Always there is deep contrition, renewed earnest promises 
of reform, and a sincere and often successful attempt to 
repair the damage done to health and character, a period 
of successful decorous life, and again a sudden plunge 
into alcoholic excesses. "Many men who fall into per- 
sistent drunkenness are unaware of their neuropathic 
heritage of unsteady nervous organism bequeathed to 
them through alcoholic or other depressing influences 
operating in their ancestors. Not understanding the 
tyranny of their unstable system, they censure themselves 
as fools for each bout of drinking, resolving and re- 
resolving not to do it again, and then go on and do the 
same unless aided by medical art to overcome the tyranny 
of the degenerated organism" (C. H. Hughes in Alienist 
and Neurologist, Jan., 1894). 

Several marked cases of this class of inebriate have 
been under my care or observation at various times. 
Nearly all belonged to alcoholic families. One I treated 
several times for incipient delirium tremens. Twice dur- 
ing periods of remorse following protracted debauches, 
while consulting me in my office, the unfortunate man 
fell upon his knees and with tears streaming from his 
eyes and hand uplifted, against my protest, made a most 
solemn oath never again to drink another drop of alcoholic 
liquor. Scarcely two months after his last interview with 
me, I saw him again in the beginning of another drinking 



148 SHALL WE DRINK WINE ? 

bout. He was active, noisy, irritable, grandiloquent, 
arrogant, and proud. He took it as a serious personal 
affront when I drew him aside to remind him of the 
danger of his condition, declaring that he was quite 
competent to take care of himself without any outside 
interference. This man had large business interests and 
possessed more than an average amount of intelligence 
and business capacity. He was of distinct alcoholic 
heredity. 

Another case was that of a fairly intelligent man who 
had periodical attacks of great restlessness, attended by 
dizziness, slight mental confusion, headache, and sleep- 
lessness. At the same time an intense desire for liquor 
possessed him, and he drank excessively for one or two 
weeks, then, suddenly stopped and resumed his daily 
avocation, which was a minor judicial office. Unlike most 
inebriates, he consulted me during a sober interval. He 
fully appreciated his condition, and described it minutely 
and intelligently. The periods occurred independently of 
any surrounding circumstances, and varied in frequency 
from six or eight weeks to three months. The attacks 
began with mild disturbances, but increased in severity 
until he was compelled to seek relief in alcohol. He was 
advised to keep on hand a mixture of chloral, potassium 
bromide, and tincture of capsicum, and to take it in 
quantity sufficient to allay his nervousness as soon as it 
appeared. He was also advised to remain at home for a 
day or more, to avoid being irritated by the petty annoy- 
ances of his office. This simple expedient kept him from 
alcohol for more than two years. At the end of that time 
he lapsed once more into his old habit, but the debauch 
was not severe, and he declared he made it voluntarily 
to celebrate a local political victory. He was under 
observation for nearly a year after this, but no knowledge 
of any further backsliding came to me. 



INTERMITTENT OR PERIODICAL INEBRIETY. 149 

Three brothers of this inebriate were known to be 
drunkards. One of them, however, was a successful 
business man, who, though he drank at times, still pos- 
sessed sufficient self-control to prevent his excesses from 
becoming very conspicuous. Another brother has 
been a drunkard for many years. He drinks con- 
tinuously and indulges frequently in conspicuous ex- 
cesses. The third brother was a typical alcoholic de- 
generate of the periodic type. I attended him through 
an attack of alcoholic mania characterized by violence, 
delusions of persecution, and destructive tendencies 
— homicidal, suicidal, and property. Immediately after 
recovering from this maniacal attack, when the nor- 
mal functions were all re-established, he escaped from 
his room during the absence of his attendant, and returned 
in a few hours in a maudlin condition of intoxication. He 
was then locked in a cell and kept until his desire for 
alcoholic liquor could be controlled. 

The time elapsing between any two successive narcotic 
debauches varies much with different inebriates and at 
different times with the same inebriate. In some the 
nervous tension is always at the same level and needs only 
the occasion, the presence of favorable circumstances, to 
insure a narcotic excess. A commercial traveller who 
had his work arranged so that he would visit a certain 
town once in three months, and afterward once in six 
months. Here he had to wait a week before resuming 
his travels. He invariably seized this occasion for a drink- 
ing bout, four times a year when occasion permitted it, 
but only twice a year when the old order of things had 
been changed. Here, it would seem, the periodicity was 
determined by the periodicity of his visit to this particular 
town. 

Examples of this kind are numerous. Many inebriates 



150 SHALL WE DRINK WINE ? 

are controlled by the presence of a wife, a mother, or a 
sister, but the absence or death of the relative removes the 
restraining force under which the degenerate may have 
fretted and silently protested, and he at once plunges into 
the excesses toward which he was so long inclined. 
Periodicity may, therefore, be determined by the periodicity 
of occurrence of favorable circumstances and have the 
same variations. 

Another kind of periodicity is that which seems to be 
the result of accumulated nervous irritation. It is as 
though a successive train of electrical impulses were sent 
into a Leyden jar, which finally becomes charged and is, 
electrically speaking, in a condition of unstable equi- 
librium, exploding when it becomes surcharged. An 
inebriate of this kind has tolerably regular intervals of 
drunkenness, for, no matter what the surroundings may 
be, to drink is inevitable. 

Still another type is epileptic in character. There may 
be long intervals of perfectly sane decorous conduct, with- 
out nervous perturbation of any kind, when the subject 
is taken by storm and seeks immediate relief in alcoholic 
or other narcotic intoxication. This type is sometimes seen 
in women, coinciding with the menstrual function. I have 
seen a marked example of it in a clergyman's wife who 
invariably became drunk on port wine with the recurrence 
of each menstrual period. 

By far the greater number of periodic inebriates, how- 
ever, are those of unstable mental equilibrium, in a 
constant state of mental depression and irritation, who 
suffer from ennui, tedium vitae, whose intercourse with 
the world is fatiguing, who find no joy in occupation, 
who are given to introspection, and who find their very 
existence painful. Losses of any kind, in business or of 
friends, or anything else which may add to the burden 



INTERMITTENT OR PERIODICAL INEBRIETY. 151 

imposed by existing degenerate conditions, may make 
that burden too painful to be borne, and relief is sought 
in the nerve deadening effects of narcotic drugs, chiefly 
in alcohol. 

Many cases of periodic inebriety are difficult of classi- 
fication. Certain susceptible individuals seem to be 
markedly affected by atmospheric conditions. Heat, 
cold, moisture, electrical tension and the like, may develop 
a latent desire for drink which would have otherwise 
remained dormant. In certain other cases there seems to 
be absolutely no cause for occasional bouts of drunkenness 
but the pleasure of gratifying the physical taste for some 
form of alcoholic drink. Drunkards of this kind often 
have their debauches in solitude and consume only a 
special brand of spirits or wine. Their periods of excess 
are, in some cases, at least, far apart. For example, there 
is the case of a well-known professional man who once a 
year drank large quantities of a certain brand of whisky. 
Preparations were always deliberately entered into, a local 
druggist being asked to have on hand a stated amount 
of the intoxicant for the occasion, which always took the 
form of a fishing excursion lasting from one to two weeks. 
His only companion was a trusted man-servant. During 
the remainder of the year he abstained from alcoholic 
beverages absolutely. Another example was that of a 
wealthy and venerable philanthropist who, every summer, 
engaged a suite of rooms in a prominent hotel of a distant 
city, and in the seclusion of his apartments drank enormous 
quantities of a particular brand of champagne. Ten or 
twelve days thus spent sufficed to satisfy him for the whole 
year. Perhaps we may regard these cases as we would 
cases of simple gluttony, excesses to gratify a momentary 
taste, without any craving on the part of the nervous 
system. 



XVI. 
JVon-Interoritttng or Constant Inebriety* 

The periodic inebriate or the occasional drunkard may 
become the constant inebriate. Sometimes inebriety is 
constant from the beginning, but this is not common. 
The same causes which produce the one form produce 
the other. In the writer's experience, the sound man 
of good heritage who acquires the habit of drinking 
is more likely to become a constant than a periodic 
inebriate. He creates the necessity for narcotic sedation 
by his excesses. Some drunkards daily take a sufficient 
quantity of alcohol to produce a certain state or degree 
of intoxication for months at a time, exhibit no periods 
of irregular conduct, attend to their daily duties with the 
utmost regularity, and finally die of some acute inflamma- 
tion or some chronic disease engendered by alcoholic 
irritation. Many of this class have no history of degenera- 
tion of any kind. They become the victims of favorable 
opportunity. They are men of means and leisure, without 
definite aims in life, to whom normal existence has become 
dull. Employment may also favor constant drinking. 
The wine merchant becomes a constant inebriate from 
drinking his wares with his many customers. So does 
the distiller and his salesmen; but more particularly do 
the laborers engaged in the manufacture of alcoholic 
liquors become drunkards. It is the habit of employes in 
such places to have a definite amount of the beverage 
manufactured set apart for each individual daily. The 



NON-INTERMITTING OR CONSTANT INEBRIETY. 153 

laborer is very jealous of his "rights" in this respect and 
I have heard of a strike threatened because of a suggestion 
on the part of a brewer to reduce this daily allowance of 
beer. The amount allowed to each workman is probably 
always sufficient to keep him in a continual state of in- 
toxication. I have it on good authority that some brewers 
of Germany allow each workman eight liters of beer for 
his individual consumption (a liter is 2. 113 pints). Esti- 
mating beer to contain from three to eight per cent, of 
alcohol, the amount of alcohol consumed daily by each 
man would be from one to two and two-thirds pints. 
Whether this custom is universal in America, I cannot 
say. It is observed, at least, in some breweries, but 
whether it is observed or not the brewery employe is 
pretty sure to keep himself saturated with alcohol and 
exhibit its damaging consequences. A medical friend who 
has considerable practice among these men declared that 
many of them "are walking pathological museums.'' 

Similarly, bartenders, porters, and other servants em- 
ployed where intoxicating liquors are sold, readily acquire 
the habit of continuous excessive drinking, without the 
existence of any abnormal appetite for drink, but simply 
because the drink is easily accessible. 

Very liable to lead to constant inebriety is the habit 
of keeping late hours combined with the drinking of 
alcoholic liquor in quantity to produce slight intoxication. 
Indulged in, night after night, as is often the case with 
young men of the store, the bank, or the lawyer's office, 
they find that the day's work must begin with an aching 
brain and exhausted body, which may be temporarily 
relieved by a "bracer" of brandy. When exhaustion thus 
produced becomes marked, a repetition of the dose at 
frequent intervals during the day may become imperative 
to enable the debauchee to do his work, and the way is 
soon paved to continuous inebriety. 



154 SHALL WE DRINK WINE? 

There is a general but ill defined opinion that the con- 
tinuous inebriate, unlike the periodic inebriate who is the 
victim of an insane impulse, is somehow personally 
responsible for his drunkenness, and there is some founda- 
tion for this opinion. It is not that the voluntary inebriate, 
if the expression can be allowed, does not become a de- 
generate and does not suffer from the withdrawal of his 
habitual narcotic, but that he began his habit of drink a 
free man, unhampered by any resistless impulse bequeathed 
to him by degenerate parents or acquired by other means 
than alcohol. 

As a corollary to the fact that habit alone, without pre- 
existing degeneracy, may lead to continuous inebriety, 
is the fact that this sort of inebriate is most readily 
reformed or cured. If great and permanent damage has 
not been suffered by any important organ, and he is 
intelligently supported during the nerve storm, following 
the withdrawal of alcohol, until he has regained his usual 
standard of health, he is certainly not so liable to lapse 
into his old habits as he would be if he had some congenital 
fault to deal with. Here, again, blame should attach to 
him should he, after complete recovery, again form habits 
which would lead to inebriety. 

The amount of damage done by alcohol which may be 
repaired by patient and judicious treatment cannot be 
definitely stated. It is not uncommon to meet with cases of 
complete recovery after evidence of most profound nerve 
degeneration — partial paralysis, incoordination, pares- 
thesia, anesthesia, hyperesthesia, marked disturbances of 
the special senses, and the like. Physicians who have had 
considerable experience with drunkards will readily recall 
examples of this kind. 

One such case under my observation for a time ex- 
hibited signs of most marked degeneration. The muscular 



NON-INTERMITTING OR CONSTANT INEBRIETY. 155 

system was atrophied, he suffered intense pain and inco- 
ordination in the lower extremities, complete anasthesia 
of one foot, and amaurosis to such an extent that he could 
not read, nor even oversee the work of his employees (he 
was a master plumber). A complete withdrawal of alco- 
holic liquor was followed by prompt improvement, and 
within eighteen months he had apparently reached his 
normal condition of health. Nearly seven years have since 
elapsed, but there has been no recurrence of his old 
habit. 

Not only under intelligent medical handling may inebri- 
ates of this class recover, but they sometimes exhibit a sur- 
prising amount of will power and enter almost single- 
handed into the struggle against the bestiality to which 
they have sunk. Generally the determination to reform is 
the result of some profound impression, fear of speedy 
death if the habit is continued, a religious revival, a disaster 
to family or friends for which the drunkard thinks he is to 
blame, or the dying request of a neglected wife or mother. 

A "homesteader" in a pine forest of northern Wiscon- 
sin, whose nearest neighbor was several miles away, left 
his wife, who was about to be confined, to call a physician 
in a village about ten miles away. On arriving he found 
that the physician was absent and would not return before 
two or three hours. He then went to a saloon, of which 
he had for a long time been a liberal patron, to get his 
jug filled and await the doctor's arrival. Here alcohol soon 
made him oblivious of his urgent errand, and not until 
the next day did he return to his home, where he found 
both his wife and baby dead. The calamity was sufficient 
to make him abjure alcohol for sixteen years. 

A young man of good heritage became a constant 
inebriate through social influences alone. For a period 
of eight or nine years he had not been free from alcoholic 



156 SHALL WE DRINK WINE? 

intoxication for a single day. At the end of this time he 
had become unfit for any kind of labor. He had the 
usual symptoms of nerve degeneration, with marked 
psychic disturbances. For these he called his physician, 
and asked an opinion as to whether his condition was 
dangerous to life. He was candidly told that he might 
die in a short time, and that he certainly would die within 
two years if he continued his course. With only a very 
little help from his physician he fought out the battle, and 
at the end of four or five weeks he could enjoy a normal 
existence without any narcotic. Eight years have elapsed 
without a revival of his old habit. 

The history of another young man under the writers 
observation is almost identical with the above. The latter, 
however, drank more alcohol and showed profound nerve 
degeneration, especially of sight. Fear of losing this im- 
portant sense started him on the road to reform. He, 
however, accomplished the result quite singlehanded, re- 
jecting proffered medical aid. His cure has persisted up 
to the present, a period of more than five years. A wealthy 
lumberman had been a drunkard from the age of eighteen. 
For many years he habitually became intoxicated on 
Saturday afternoon and continued so until Monday or 
Tuesday morning. Besides this he drank more or less 
during the remainder of the week. Four or five years 
previous to his reformation he became a continuous 
drunkard, being under the influence of alcohol during his 
entire waking time. He ceased drinking at the age of for- 
ty-one, giving as his reason the fact that his wife had 
never upbraided him for his excesses, and that her christian 
fortitude, together with an overwhelming sense of the 
wrong he had done her, compelled him to attempt to re- 
form, even though the effort should kill him. 

Many other instances of partially or wholly voluntary 



NON-INTERMITTING OR CONSTANT INEBRIETY. 157 

reformation might be recalled, but cases of this kind are 
already familiar to both laymen and medical men. When a 
considerable number of them are analyzed, it is difficult to 
escape the conviction that much drunkenness is really vol- 
untary. 

Here is an appropriate place to point out more fully 
some facts, the failure on the part of the public to under- 
stand which, have made imposition by commercial inebriate 
institutions possible. These people send out broadcast un- 
qualified assurances that they "cure inebriety," assuming, 
of course, that it is a definite specific disease. Many guar- 
antee to "cure" it in from four to six weeeks. Their clients 
are instructed and assured that this method of cure abso- 
lutely abolishes all desire for alcoholic liquors. Not only 
this, but the former appetite for strong drink is replaced 
by deep-rooted and permanent abhorrence for alcoholic in- 
toxicants. Their proposition may be stated thus: "You 
have had the specific disease called inebriety. You are now 
cured. Instead of having an appetite for alcohol, you now 
have and always will have an aversion, unless you again 
begin to drink voluntarily. Should you again begin to drink 
alcoholic beverages, you will again get the disease of which 
you have been cured." It is unnecessary to point out the 
puerility of such arguments. I have known a young man 
just returned from an institution which promulgates this 
doctrine declare to a group of old convivial friends that 
even the smell of liquor nauseated him, and that he felt sure 
that he not only would never but could never again drink 
spirits, and then die as the result of a drunken debauch four 
months later. I attended a man for delirium tremens re- 
sulting from a debauch which began the second day after 
he left this institution, cured, as he was told. A patient un- 
der treatment at the present time for syphilis was cured of 
inebriety in six weeks. A few months afterward he began 



158 SHALL WE DRINK WINE? 

his old excesses and for a year or more drank more than 
ever before taking the cure. He then ceased voluntarily, 
and for two years has been trying to repair his shattered 
fortunes. A friend upon whose word the utmost reliance 
may be placed told that he was an eye witness to the fol- 
lowing incident: A train bearing several returning ''cured" 
inebriates to a certain city in the west stopped for a time at 
a way station. Here the returning prodigals met an equal 
number of the unregenerate on their way to the institu- 
tion the former had just left; good-fellowship overcame 
all restrictions and the "cured" and "uncured" got drunk 
together. 

Many inebriates return to those institutions again and 
again. A brilliant scholar known to the writer is now un- 
dergoing his sixth or seventh "cure." Many others are 
known to have been treated by the same method two, 
three, four, five, or more times. A few do not fall from 
grace after taking the treatment once. If a record were 
kept of all the inebriates thus treated for a period of five 
years after being discharged as cured, the number which 
had not relapsed would be found to be very small. In the 
experience of the writer and, as far as can be learned, that 
of other physicians, those permanently benefited are almost 
invariably constant inebriates who become such, not 
through any inherited or other defect of the nervous or- 
ganization, but through the habit of social drinking; ine- 
briates of the periodic type, the victims of a true degener- 
acy, are rarely, if ever, benefited even for a short time. This 
result is precisely what ought to be expected when the sub- 
ject of inebriety is understood. 



XVIL 

popular fallacies Regarding Common Hlcobolic 
Beverages. 

Perhaps three-fourths of the intelligent people of Amer- 
ica believe that alcoholic beverages "taken in moderation" 
are beneficial. A brilliant German woman once said to me, 
"I use water only to bathe in." She spoke the sentiment of 
the German people as to the use of water as a beverage, 
for no German is so poor that he will not spend a few pfen- 
nigs for beer to drink with any meal excepting breakfast. 
The Frenchman, though he has recently become some- 
thing of a beer drinker and has increased his allowance of 
spirits, still keeps up the traditions of his ancestors in his 
devotion to wine. Similarly in other European countries 
water as a beverage is eschewed by all classes of society, 
and liquors containing alcohol are almost universally sub- 
stituted, because they are believed to be more beneficial in 
promoting and maintaining the health. There is a curious 
popular belief among the majority of uneducated foreign- 
ers that the drinking of water causes bodily weakness by 
making the blood "thin/' and the physician is sometimes 
asked if this is not true. 

Spirituous liquors, whiskey, brandy, gin, rum, and oth- 
ers, containing forty to sixty per cent of alcohol, are popu- 
larly believed to be stimulating when taken in small quan- 
tities. As the only active principle they contain (excepting 
gin) is alcohol, their action is the action of alcohol, and 
whether alcohol is a stimulant or not has already been 



160 SHALL WE DRINK WINE ? 

fully discussed in this work. In the normal man not habitu- 
ated to the use of narcotic drugs, in spite of the delusive 
sensation of increased mental and physical power which 
follows the ingestion of a small drink of spirits, muscle and 
nerve capacity is, in the sum total, always lessened. This has 
been conclusively proved by Richardson and others 
through actual experimentation. 

There is also a popular belief that these strong bever- 
ages contribute to the physical well-being under conditions 
of fatigue due to excessive physical exercise, especially if 
the exercise is taken in a cold and wet atmosphere. A habit 
prevails extensively, among workingmen, of taking a drink 
of spirits at the close of a hard day's labor, when fatigue is 
so great as to become painful. Seafaring men, soldiers on 
a march, sportsmen, and others whose employment makes 
exposure to the inclemencies of the weather necessary ha- 
bitually drink spirits to lessen the unpleasantness of expos- 
ure and make their necessary tasks easier. Here again we 
meet with the familiar delusion that narcotism is strength. 
Undoubtedly the sense of fatigue is lessened or abolished, 
but the chemical conditions causing the fatigue remain the 
same as they were before the ingestion of the spirits, the 
sensory nerve endings having simply been narcotized into 
a temporary quiet. Morphine or any other narcotic pro- 
duces percisely the same effects. Perhaps alcohol is the 
least offensive narcotic under these circumstances, but it is 
a narcotic nevertheless. If exercise is continued after the 
irritations of fatigue are temporarily lulled to rest, muscle 
and nerve wear and tear still continue. They are not abol- 
ished simply because they are not felt. A condition of over 
fatigue thus results, to recover from which requires a long- 
period of rest; therefore nothing is gained, but there is 
always a loss due to the temporary derangement of the vital 
functions by the action of the narcotic. 



FALLACIES REGARDING ALCOHOLIC BEVERAGES. 161 

Similarly, while a drink of spirits seems to warm the 
subject chilled by an unexpected bath in icy waters or a 
downpour of cold rain, actual investigation by precise 
methods shows that the bodily temperature is always low- 
ered when a sufficient quantity of alcohol is taken to affect 
it at all. 

The stronger alcoholic beverages are popularly be- 
lieved to increase the bodily weight, to give embonpoint 
and the color of health. Even some members of the med- 
ical profession hold this view. A recent writer (Practical 
Dietetics, Thompson, P. 207) makes the following pecu- 
liar statement of those who use alcohol: "In the condition 
of health more food is eaten and more force developed than 
is actually necessary for the body, and there is constantly 
a reserve supply of energy on hand which may be used for 
any extraordinary exertion, and hence the constant use of 
alcohol as a food or stimulant is both unnecessary and un- 
advisable." An analysis of this confusing statement would 
seem to make it mean that the habitual taking of alcohol in 
the form of spirits leads to an exaggerated condition of nu- 
trition by stimulating the appetite so that more food is 
taken than is needed, and that the surplus is stored up in the 
form of reserved force. The physiological principles which 
make this impossible in the normal subject have already 
been discussed. Suffice it here to say that spirituous liquors 
such as brandy and whiskey have no more power to in- 
crease the weight of the normal man than have sulphuric 
ether or chloroform, and that when a drunkard is well 
nourished or fat he does not confine himself to these 
alcoholic beverages alone, but drinks others containing 
food substances. The writer has never yet seen a drunk- 
ard who drank spirits alone who became fleshy, but the op- 
posite condition of emaciation always prevailed. Says Dr. 
Norman Kerr on this point (Alcoholism and Drug Hab- 



162 SHALL WE DRINK WINE? 

its) : "Spirits drinkers as a rule are more shrunken in aspect 
and often grow thinner the longer they continue their deep 
potations till, in many cases, they are quite emaciated." As 
to the rosy color of the spirits drinker's face, that is due to 
the paralysis of the vessel walls leading to permanent dila- 
tation, especially of the superficial blood vessels of the face. 
Spirits are commonly taken by one who feels the neces- 
sity of being braced up to meet a mental ordeal or to tide 
him over a period of mental perturbation from any cause. 
Here again it is not the stimulant which relieves, but the 
narcotic, by making the nervous organism less impression- 
able to irritating influences. Lastly, spirits are very com- 
monly taken to ward off infection in the presence of epi- 
demics of contagious disease. Confidence in the efficacy 
of strong brandy and whiskey for this purpose is wide 
spread. No advice of the physician was more common a 
short time ago than that instructing the throat to be gar- 
gled with brandy and small quantities of it to be swallowed 
to ward off an attack of diphtheria. Blood poisoning from 
an infected wound was also combated with large doses of 
strong liquor. To-day the physician can demonstrate that 
infectious diseases are made more formidable by the giv- 
ing of spirits, but the laity will be a long time learning this 
important fact. Especially are malt liquors supposed to 
be of exceptional value in contributing to the physical 
well-being of man. Beer and ale are supposed to have an 
important tonic and food value, while the amount of alcohol 
they contain is looked upon as harmless. The opinion is 
expressed on every hand that the drinking of beer should 
be encouraged, because it tends to produce temperance — 
the more beer that is drunk, the less spirits will there be 
drunk. Indeed, it is difficult to appreciate to what extent 
beer is regarded as one of the prime necessaries of life with 
the people of some European countries and their Amer- 



FALLACIES REGARDING ALCOHOLIC BEVERAGES. 163 

ican descendants. With some of these people, not to drink 
beer is to be considered eccentric, and to doubt its whole- 
someness and desirability as a beverage is rank heresy, 
while to publicly oppose it is regarded as a dangerous 
degree of fanaticism. 

Beer is a mixture of alcohol, sugar and dextrine, car- 
bonic acid, the bitter principle and some other constituents 
of the hop, tannic acid derived from the hop or from veg- 
etable matter used for coloring purposes, and water. The 
effects of beer are precisely the effects of its constituents if 
taken separately but simultaneously. The alcohol in beer 
produces drunkenness just as it does when taken in any 
other form, and as beer and ale contain from three to twelve 
per cent of alcohol the amount ingested will depend upon 
the kind and amount of beer drunk. Four per cent beer 
may produce unlimited alcoholic intoxication. Massachu- 
setts passed a law in which an intoxicating liquor was de- 
fined as one containing four per cent of alcohol or more, 
but so much drunkenness could be produced by a beer of 
this strength that the law was afterward amended so as to 
define an intoxicating liquor as containing alcohol to the 
extent of one per cent or more. There can be no doubt 
that many hereditary appetites for alcohol are first aroused 
by drinking beer. 

There is considerable variation in the amount of sugar 
contained in different malt liquors. If the sugar and dex- 
trine be taken together, as they have the same food value, 
the amount would be found to vary from two and a half to 
three per cent or more in the heaviest ales and porters. Ex- 
cepting the very small amount of proteid matter contained 
in malt liquors, which is so small that it may be disre- 
garded, sugar alone of all ingredients has a definite food 
value. There is a popular belief, and it is not confined to 
the laity exclusively, that malt sugar, which is found in 



164 SHALL WE DRINK WINE? 

malt liquors, is superior to the ordinary sugar of commerce, 
in being more easily digested and assimilated. There is, 
however, no foundation for this assumption. Indeed, phys- 
iologists know that all sugars are changed into the ordi- 
nary grape sugar of commerce before being finally ab- 
sorbed and converted into mechanical force. This assump- 
tion probably had its origin in the belief that diastase ex- 
isted with malt sugar and aided the digestion of starch. 
Diastase, however, is killled by the high temperature of the 
brewing process. 

Sugar is an important and easily assimilated food. 
Taken in excess of daily need, it is stored up as fat, and to 
the sugar alone is due the obesity of the beer drinker. In 
addition to an abundant supply of fat, the beer drinker also 
develops the ruddy countenance of the spirit drinker, due 
to the same cause — alcoholic paralysis of the superficial 
blood vessels. But sugar is not a perfect food. Taken 
alone it will not support life indefinitely. If taken to the 
exclusion of a proper amount of nitrogenous food, the 
subject soon becomes debilitated, and may suffer from 
fatty degeneration of some important organ. Thus the 
beer drinker, while he is generally ruddy and in good flesh, 
may be far from the normal standard of health. With con- 
tinued excessive drinking of malt liquor, the great accumu- 
lation of flesh and purple face show even to the unprac- 
ticed eye evidence of serious disease. I cannot do better 
than to quote from Dr. Norman Kerr the characteristic 
appearance of the malt liquor drunkard: "In beer and 
other malt liquor drunkards the subject at an early stage 
has a tendency to obesity which, as the disease advances, 
becomes more prominent, till he acquires a bloated appear- 
ance, purring and blowing with the slightest exertion. The 
features are heavy and dull, the face red and somewhat of 
a purple hue, with vascular hypertrophy most conspicuous 



FALLACIES REGARDING ALCOHOLIC BEVERAGES. 165 

in the region of the eye and nose, with blotches and an oily 
glistening surface, conjunctival yellowness (bilious or fatty), 
moist red eyes. In the early stages the beer drinker 
may be quick and active, but gradually his gait loses much 
of its elasticity, he looks sluggish and embarrassed in his 
movements. Dropsy or syncope or embolism frequently 
closes the scene in middle life." 

A peculiar demonstration of the fattening power of 
sugar in a drunkard was recently brought to my notice by 
a professional friend. He had under his care for some 
time an inebriate who drank from forty to sixty glasses of 
whiskey daily, and, not liking the taste of whiskey, he al- 
ways poured into the glass an equal amount of plain syr- 
up. This practice he had continued for several years, and 
when he applied for treatment the flesh hung from nearly 
all parts of his body in "flabby, yellowish folds," and he 
was enormously fat. 

Again, the beer drinkers of Germany are almost with- 
out exception fleshy, while here in America I have seen 
many beer drinkers decidedly lean; on examination of sam- 
ples of imported and domestic beers it is found that the 
German beers do contain more sugar than the domestic 
article. In some instances, at least, the difference is as 
great as three or four to one. 

The carbon dioxide and bitter principles of the hop give 
to beer much of its pleasant taste, and probably have some 
influence in the way of increasing the flow of gastric juice. 
Tannic acid, on the other hand, of which some beers con- 
tain a considerable quantity, has a deleterious influence on 
digestion. It is a well-known fact that this substance has 
the property of combining with albumen and the various 
peptones, forming with them insoluble compounds and 
thereby perventing their proper digestion and assimilation. 
Dr. Lambert Ott of Philadelphia, speaking of the acute di~ 



166 SHALL WE DRINK WINE ? 

gestive troubles of beer drinkers, says (Medical News, Jan. 
6, 1894) "of one hundred cases of this disease (inflamma- 
tion of the lining membrane of the stomach) seventy-eight 
occurred in June, July, and August from pouring cold beer 
into an empty stomach. In fact, the drinking of beer pro- 
duces the same disturbances that are produced by any liq- 
uor containing alcohol in the same proportion, with the 
added trouble that comes of tannic acid and the usual adul- 
terations that are in beer." In the beers examined by me 
the amount of tannic acid varied considerably. Certainly 
there was enough in some of the specimens examined to 
produce serious disturbance of the digestive processes. 

Of all the alcoholic beverages none are held by the ma- 
jority of civilized people to have the transcendant virtues 
of wine. No other food or beverage has commanded so 
much adulation from all kinds and conditions of men. It 
occupies so important a place in all the best literatures of 
the world, in which its desirability, its wholesomeness, its 
divinity, are the subject of effusive encomium, that to com- 
pile a catalogue of its votaries' praises would require a 
much longer time than is vouchsafed to a single human 
life. Its worship is sincere and deep rooted, and its wor- 
shippers are among the world's greatest and best men. 
It is amazing, when one stops to consider the matter, how 
little foundation there is for the average man's opinion as 
to the value of wine. Good wine, in his estimation, is al- 
ways desirable. He may abhor drunkenness, look upon 
the drinking of spirits as dangerous and demoralizing, 
regard the drinking of malt liquors with contempt ; and yet 
he may consider the drinking of a bottle or more of wine 
each day as a duty which he owes to his health, his mater- 
ial success in life, or his social position; and he is apt to re- 
gard the contents of his wine cellar as one of his greatest 
treasures. If he is asked the reason for the value he puts 



FALLACIES REGARDING ALCOHOLIC BEVERAGES. 167 

upon his wine, he certainly cannot call attention to its in- 
trinsic worth, for he is not a chemist nor a physiologist. His 
answer must be that it cost him a large price per bottle, that 
it was made at a famous "Chateau" and that the wines from 
this place are always high priced; that it was part of the 
contents of a famous wine cellar which was recently sold, or 
that it is many years old and came to him through the will 
of his father, grandfather, or some other relative. 

No error, by the way, is more common than that which 
gives increasing value to wine with increasing age. This 
value is looked upon as something very real and potent. 
New wine may be thought unfit to drink. The same wine 
after ten years is considered good and commands a high 
price; but let this same wine acquire an age of a hundred 
years or more, and it now commands a fabulous price and 
is looked upon as a veritable elixir vitae. One is gravely 
told even by intelligent men that, no matter in what quan- 
tity drunk, such wine is never harmful. It will surely pro- 
duce drunkenness when taken in sufficient quantity, but 
even drunkenness produced by it leaves no bad after ef- 
fects. Good wine is supposed to be tonic and stimulating. 
Red wine is believed to have the power of making "red 
blood." Good wine is supposed to be always beneficial. 
When injury is done by wine it is not the wine which is 
believed to have done the injury, but the suspicion of adul- 
teration is at once aroused. All the value which the wine 
possesses may be estimated by considering the substances 
which enter into its composition. They are water, sugar, 
tartaric and acetic and a small amount of malic, tannic, 
and carbonic acids, various salts derived from the grape, 
like the tartrates of lime and potash, and sulphate of potash 
and lime, chloride of sodium, potash, and lime. These salts 
vary in amount from .2 per cent, to .4 per cent. Wine also 
possesses a peculiar aroma which is known as "bouquet." 



168 SHALL WE DRINK WINE? 

The amount of alcohol contained in wines varies from 
three to thirty or more parts by weight. It is thus seen 
that some wines may do nearly as much damage as whis- 
key or brandy. Sugar varies from practically none in the 
dry wines to twenty-five per cent, or more in the sweetest 
wines. As sugar is the only constituent of wine possessing 
a food value, the value of wine as a food will depend upon 
the amount of sugar it contains. It is quite probable that 
the malic and acetic acid, and perhaps the tartaric, of wine 
may aid digestion by reinforcing the gastric juice in cases 
of insufficiency, and therefore promote gastric digestion. 

The bouquet and flavor of wines are due to the devel- 
opment of certain volatile substances by the reaction of 
acids upon alcohol. These volatile substances belong to 
the chemical group known as Ethers. In quantity they 
are intoxicating, and much more injurious than alcohol, 
but they exist in such small amounts in wine that they 
serve merely to give its peculiar odor and taste. The de- 
velopment of the bouquet to its fullest extent requires a 
long time, and this alone makes old wine so much pre- 
ferred by wine drinkers. In all other respects there is abso- 
lutely no difference between old wine and new. 

Comparing wine with malt liquor, it will be seen that 
the latter has more nutritive value than the former because 
it contains the greater amount of sugar. The sweetest 
wines, it is true, contain more sugar than the average malt 
beverage, but sweet wines find little favor with wine drink- 
ers, dry and sour wines being preferred. Champagne con- 
tains quite a large percentage of sugar, but its cost limits 
its use to comparatively few. The wine drunkard is not, 
therefore, liable to present the bloated, puffy, flabby ap- 
pearance of the malt liquor drunkard. Wine is also lacking 
in the bitter principle which gives beer a slight tonic value. 
Wine has no tonic effect beyond that from the food value 



FALLACIES REGARDING ALCOHOLIC BEVERAGES. 169 

of its sugar and the slight aid its acids may give to diges- 
tion, and it "stimulates" or narcotizes according to the 
amount of alcohol it contains. 

There is a wide-spread belief that all the common alco- 
holic beverages are more or less adulterated with harmful 
substances, and that the damage done by them is not so 
much due to the beverages themselves as to the poisonous 
drugs used as adulterants. Many persons willingly drink 
the currant, grape, and other wines made within the pre- 
cincts of the household who could not be induced to drink 
the ordinary article of commerce. Indeed, one frequently 
hears the praises of the domestic article sounded for its 
wholesomeness and its purity. A few years ago, when one 
of the Southern States assumed the duties of dispensing 
liquors to the public, a great deal of opposition to the plan 
was silenced by the assurances on the part of the Governor 
and his followers that under state authority the liquor sold 
would be pure. Also, in other states in which stringent 
laws were passed to regulate the liquor traffic, provisions 
were incorporated to prevent the sale of adulterated liq- 
uors, with the hope of lessening the evils attending their 
consumption. Those who speak of the prevalence of liquor 
adulterations, however, rarely make any specific charges as 
to the material used for adulteration purposes. Now and 
then one hears of spirits being mixed with "impure alco- 
hol," fusel oil, and the like. As a matter of fact, however, 
the ordinary sophistications of spirits are harmless. They 
are added with the desire of increasing the bulk, and con- 
sequently the profits of the sale of the liquor. For this 
purpose the most common adulterants are water, to in- 
crease the bulk, and caramel or burnt sugar to maintain 
the proper color; and these not only are not harmful, but 
render spirituous liquors less irritating by decreasing the 
amount of alcohol. 



170 SHALL WE DRINK WINE? 

While "impure alcohols" are widely spoken of by both 
physicians and laymen as being used to adulterate liquors, 
and especially wine, no one has yet pointed out the nature 
of the impurities. The most common and almost only im- 
purity met with in ethyl alcohol, the ordinary alcohol of 
commerce, is water. During the process of fermentation, 
however, other alcohols popularly known as fusel oil are 
also produced. These have a higher specific gravity and a 
higher boiling point than ethyl alcohol, but some of them 
generally pass over with the ethyl alcohol during the 
process of distillation.* With the process of time they are 
supposed to be oxidized into volatile ethers and so 
removed. New whiskey, therefore, is supposed to be 
very injurious because of its contained fusel oil, which is 
regarded as an especially potent poison. As a matter 
of fact, recent investigations have shown that there is 
no warrant for concluding that these heavier alcohols 
are removed by the process of "aging" of spirituous 
liquors, and while they are shown to be more irritating 
than ethyl alcohol, they are by no means as poison- 
ous as they are popularly supposed to be. Recently an 
English chemist, A. H. Allen, in experiments made on 
himself, has shown that much larger quantities of fusel oil 
than any whiskey could contain are borne without any 
apparent deleterious effect, and a friend of the chemist 
took a large dose of it without serious after effects. 

Many wines are undoubtedly "fortified" by the addition 
of alcohol, but the alcohol thus used is probably not im- 
pure in the sense of being made more harmful. Popularly, 
also, wines are believed to be colored with haematoxylin 
and their roughness increased by the addition of alum. No 
authentic evidence, however, has yet been produced to 
show that this custom is at all common. 

As to the adulteration of beers, a great deal has been 



FALLACIES REGARDING ALCOHOLIC BEVERAGES. 171 

said, and probably with some foundation. Glucose is said to 
be added to save the expense of using malt, but even if this 
is true it proves nothing to the detriment of beer, for glu- 
cose has the same food value as malt sugar and its products 
of fermentation are the same. The writer has it on good author- 
ity that large amounts of the leaves of some plant or plants 
are used for the purpose of coloring beer, and some of the 
beers certainly contain more tannic acid than could be 
given to them by the usual amount of hops used in brew- 
ing. The conclusion arrived at is that the surplus of tannic 
acid comes from the material used for coloring. Various 
substances are also said to be used to check fermentation, 
among them salicylic acid, boracic acid, and formaldehyde. 
If these latter drugs are used their use is not general, or 
they are used in very small quantities. The writer did not 
find them in the beer examined. Tannic acid, however, as 
has already been pointed out, may exist in quantity suffi- 
cient to cause serious digestive disturbances. 

A recent French writer, Mr. Joffroy, attaches a good 
deal of importance to the effects of the by-products of alco- 
holic fermentation, and declares that they play an impor- 
tant part in determining the pathology of chronic alcohol- 
ism (Revue Scientifique, Jan. 15, 1898). He calls atten- 
tion to the fact that many commercial beverages also con- 
tain additions to the ordinary products of fermentation, 
as absinthe, anisette, vermuth, bitters, and the like; that 
brandy contains other alcohols than ethyl, aldehydes, and 
acetic ether. He also calls attention to the various vola- 
tile substances and salts found in wine and malt liquor, 
and argues that those as well as the alcohol must play an 
important part in producing diseased conditions. There 
cannot be any doubt that absinthe produces conditions pe- 
culiar to itself, and it is likely that aromatics like anise are 
added to various made beverages in quantity sufficiently 



172 SHALL WE DRINK WINE ? 

large to produce notable effects; but he has produced no 
evidence to show that the ordinary spirits and wine of com- 
merce contain any of the natural by-products of fermenta- 
tion in quantity sufficient to cause definite pathological 
conditions. 

In conclusion it must be said that the popular belief in 
harmful adulterants of common alcoholic beverages is not 
warranted by any evidence which has thus far been 
brought to light, and that alcohol alone must be respon- 
sible for the damage done by them. 

We often hear the remark made that man in his natural 
state needs alcohol, that there is something lacking in his 
makeup which alcohol supplies, that he needs a stimulant 
and that alcohol is the universal natural stimulant. To 
support this argument the fact that nearly all primitive 
peoples make beverages containing more or less alcohol is 
pointed out, and that they readily become fascinated with 
the effects of the white man's alcoholic beverages when 
accessible. It would be interesting to know the origin of 
the alcoholic drinks of each savage people. That they were 
the result of accident in the first instance can readily be 
conceived. Savage peoples are noted for their fondness 
for sugar and sweets of all kinds. What wonder that they 
should, in their search for vegetable foods, undertake to 
save up the sweetest juices of various plants for future use, 
and what wonder that alcoholic fermentation should result 
therefrom, especially in a tropical or semi-tropical climate? 
Drinking the juice thus alcoholized, the savage then as to- 
day found it pleasing in its effects; and he would have to 
be very low in the scale of intelligence if he would not take 
the hint and purposely bring about the result which the 
accident suggested. So here, as it always has been, the 
appetite did not compel the discovery or invention of the 
alcoholic beverage; but the beverage created the appetite 



FALLACIES REGARDING ALCOHOLIC BEVERAGES. 173 

It is interesting in this connection to note that neither the 
Fuegians nor the Eskimos had any alcoholic beverages 
when discovered by the whites, and do not have any now 
excepting what they get from traders. There are no plants 
indigenous to their countries which yield juices rich in 
sugar, like those of the sugar-cane and the palm. Neither 
is there any evidence that the great tribes of the central and 
northern parts of North America understood the art of 
making alcoholic beverages, of which they are so fond. 
They had the sap of the sugar maple from which they made 
sugar, also the sap of the birch and the sugar pine. As the 
sap from all of them can be gotten only in the early spring, 
when the snow is still deep on the ground, it is quite likely 
that the lack of sufficiet warmth to produce fermentation 
prevented the North American Indian from discovering 
the secret of alcoholic fermentation. 

But primitive peoples have exhibited a "natural" ap- 
petite not only for alcohol but for many other forms of nar- 
cotic — tobacco, hasheesh, opium, coca erythoxilin, kola, 
and a variety of other vegetable substances having the 
power to produce pleasing intoxication. There can be 
scarcely any doubt that the narcotic taking of savages when 
it is not attended by religious rites is induced by that de- 
sire for blissful oblivion of the hard conditions of life which 
makes the civilized brother drown his sorrows in the wine- 
cup. 



XVIIL 

Shall the physician Cease to prescribe 
Hlcohoh 

There is no doubt that alcohol as a remedial agent 
might be forever banished from the physician's armamen- 
tarium of drugs without in any way lessening his efficiency 
in combating disease. Indeed, his hands would be 
strengthened thereby, for now he relies upon the fictitious 
food and stimulant value of alcohol to the exclusion of 
safer and infinitely better remedies. This is not mere the- 
ory. It is confirmed by no less an authority than Benja- 
min Ward Richardson, one of the acutest observers and 
most philosophic and original physicians of the century. 

In 1892, fifteen years after he had virtually retired from 
hospital practice, he was invited to become physician to 
the London Temperance Hospital, where he was left free 
to prescribe alcohol medicinally in all cases and at all times 
that he might see fit. This gave him the opportunity which 
he had long wished for to treat various diseases without 
alcohol in any quantity or form. In his own words, he de- 
clares this invitation "was so much to my taste, and the 
mode in which it came so handsomely conceived, that I 
could not help availing myself of it." Here he treated two 
hundred successive cases of serious diseases extending 
over a wide range in variety and affecting persons of dif- 
ferent social conditions, without using a drop of alcohol 
in a single case. Instead of the ordinary alcoholic tinc- 
tures he used glycerine and certain prepared waters as 



SHALL THE PHYSICIAN CEASE TO PRESCRIBE ALCOHOL? 175 

menstrua for the solution of active drugs. These waters 
were aqua opii, aqua ferri, aqua chloroformi, and others. 
His results were all that could be desired. Certainly they 
could not have been made better by the use of alcohol in 
any way. 

But many other physicians before and since the ex- 
perience of Dr. Richardson have treated diseases of all 
kinds without the use of alcohol, and their reports surely 
do not indicate that any thing was lost by leaving it out of 
the list of drugs exhibited. 

The narcotic effects of alcohol should make it of value 
in selected cases. A small quantity of it well diluted, at 
bedtime, has a decided and pleasing hypnotic effect with 
certain nervous individuals troubled by insomnia, but the 
liability of contracting a habit under such circumstances is 
very great — so great that the thoughtful physician would 
be very sure of his patient before subjecting him to the se- 
ductive influences of so pleasing a remedy. If the sale of 
alcohol were surrounded by the same safeguards that sur- 
round the sale of other powerful narcotic poisons, the dan- 
ger would be much lessened, but it is the most easily pro- 
curable of all merchandise. Some form of hypnotic less 
palatable and less easily procured should take the place of 
alcohol. The method of prescribing alcohol, too, is open to 
serious objections. Instead of receiving a prescription in- 
structing a druggist to furnish a solution containing a def- 
inite percentage of alcohol and directing that a definite 
dose be taken at stated times, the patient is instructed to 
buy a case of wine, beer, or spirits, as the case may be, and 
use it as a beverage. Certainly this method is responsible 
for the making of many drunkards. 

As a remedy for the relief of pain alcohol is so inferior 
to many other standard drugs that its use for this purpose 
need not be considered. No objection should be offered 



176 SHALL WE DRINK WINE? 

to the use of alcohol as a solvent for powerful drugs. For 
this purpose no other substance is so well adapted, for not 
only are nearly all vegetable substances freely soluble in 
this menstruum, but it serves the important purpose of pre- 
venting drug deterioration by fermentation, and the small 
amount of alcohol used in making tinctures, or added for 
the purpose of preservation, need excite no apprehension. 



XIX. 
Che effects of Hlcobol on Civilization. 

When a physiological chemist wishes to ascertain the 
probable amount of damage done by any poison which has 
been introduced into the circulation of an animal, he must 
first know the potency of the poison and the amount of tis- 
sue to be affected. To make the matter more explicit, he 
must know, for instance, how many grains of the drug are 
necessary per kilogram of animal weight to produce a fatal 
issue. He must know, moreover, how much damage is 
done and to what organs by a quantity not large enough to 
kill. This he learns by experimentation, by producing vari- 
ous degrees of toxicity extending over various periods of 
time, finally killing the animal experimented upon and sub- 
jecting its tissues to a searching examination. The toxic 
action of alcohol on the human tissues is unfortunately al- 
ready too well known, but in order to arrive at a probable 
estimate of the total damage done to the population as a 
whole, we must know how much of the poison is consumed, 
and by how many individuals. 

One of the most persistently reiterated statements in 
medical literature is that two fluid ounces of alcohol may 
be "burned up" in the body if taken at intervals, in small 
doses, during a day of twenty-four hours. This would 
equal one grain of absolute alcohol to one kilogram of 
weight in a man of one hundred and fifty pounds weight, 
an amount which Dujuardin-Baumetz found could be 



178 SHALL WE DRINK WINE? 

given to pigs "without being followed by any pathologic 
changes." Anstie put the amount one-sixth less. As a 
matter of fact, however, there is no reason for thinking 
that two ounces of alcohol ingested daily might not produce 
serious disturbances in susceptible individuals, but, as it 
seems to be accepted by the medical profession as a truth, 
it may be used as a basis of estimation in this place. 

For the total amount of alcohol consumed in any year 
we may consult the industrial statistics of the United States 
government. Here it is found that the total consumption 
of alcoholic beverages, domestic and imported, were for 
the year 1896 as follows: 

Spirits 71,051,967 gallons 

Wines 18,701,406 gallons 

Malt Liquors 1,080,626,164 gallons 

Estimating the spirits to contain 53% of alcohol, the 
wine an average of 15%, and the malt liquors an average 
of 4%, we get the following amounts of alcohol consumed 
in that year as follows : 

In the spirits 37,657,542 gallons 

In the wine 2,805,21 1 gallons 

In the malt liquors 48,628,177 gallons 

Total 89,090,930 gallons 

Taking the population of the country in 1896 in round 
numbers at seventy millions, the per capita consumption of 
absolute alcohol for that year would equal 1.27 gallons. 

But what percentage of the total population must be 
charged with drinking this enormous quantity of alcohol? 
That question is not easily answered. Here in America 
women and children rarely drink alcoholic beverages. 



THE EFFECTS OF ALCOHOL ON CIVILIZATION. 179 

They may therefore be eliminated as consumers of 
alcohol. Of the adult males, taking the urban and 
rural population together, one-half, probably, drink more 
or less of some kind of alcoholic drink. Estimating the 
adult males as one-fifth of the total population, or twenty 
per cent, this would give ten per cent of the total popula- 
tion as alcohol consumers. A medical man with whom 
this subject was discussed, thought this estimate too low — 
in his opinion, fifteen to twenty per cent of the total popu- 
laion would be nearer the truth. Certainly, however, the 
number of all occasional and constant drinkers of alcoholic 
liquors cannot be greater than twenty per cent, or one out 
of every five, of the total population. 

If ten per cent of the total population drink all the 
alcohol consumed in the ordinary beverages, this would 
give to each individual 12.7 gallons per annum, or 1625.6 
ounces, a daily quantity of 4.45 ounces or more than twice 
as much as the maximum quantity which is said to be 
eliminated from the human body without damage. 

Taking the large percentage as representing the alco- 
hol consumers, one out of every five of the total popula- 
tion, the daily amount of alcohol, 2.224 ounces, would still 
exceed the safe maximum. This method of reasoning, 
however, does little more than hint at the destructive possi- 
bilities of alcohol. As a matter of fact, there is nothing 
even approximating this equal distribution of alcohol 
among all those who indulge in any degree in alcoholic 
beverages. It would, probably, be very near the truth 
to say that three per cent of the population consume at 
least sixty per cent of the total amount of alcohol con- 
sumed, and that two and a quarter millions of our peo- 
ple, mostly adult males, are being rapidly destroyed by its 
poisonous effects, and that this destruction is going on 
constantly. To this should be added, probably, at least 



180 SHALL WE DRINK WINE? 

half as large a number of victims of hereditary alcoholic 
degeneration. 

The latent capabilities of this ninety million gallons of 
alcohol consumed in the beverages of seventy million peo- 
ple during the year 1896 can be better illustrated by show- 
ing how many adult lives could be destroyed by that 
amount of the poison.* 

Considering one pint of the absolute alcohol the aver- 
age lethal dose (it is probably much less than that), there 
would be enough in the ninety million gallons to furnish 
ten and a half fatal doses to each individual within the 
borders of our country. But one pint is a lethal dose for 
an adult. A much less quantity would suffice to destroy 
the life of a child. There was, therefore, enough alcohol 
drank every two or three weeks during that year to destroy 
the entire population if it had been taken within an hour. 
There is a general belief that the consumption of alcohol 
is decreasing. This belief is based upon the fact that the 
per capita consumption of spirits shows a slight decrease 
when compared with that of ten and twenty years ago. 
As a matter of fact, however, the rapid increase in the 
quantity of malt liquors consumed makes a steady increase 
in the total alcoholic consumption. The following table 
shows the nature and extent of that increase by comparing 
the consumption of 1886 and 1876. As the change in the 
per capita consumption of wine during these years was 
very slight, it will not be considered. In the three years 
mentioned there was the following per capita consumption 
of alcohol: 



*The letha! dose of alcohol seems to have received but little attention from medical 
men. Kayser, quoted by Demme (Einfluss des Alkohols auf den Organismus des 
Klndes, P. 13.), reported the death of a three-year-old child following: the ingestion of 
75 grams (2.3 ounces.) of undiluted alcohol. A fatal issue followed the drinking of 
330 grams CIO. 3 ounces.) by an adult. 

Demme believes that smaller doses than these would probably cause death at these 
periods of life. 



THE EFFECTS OF ALCOHOL UPON CIVILIZATION. 181 

!8 7 6 — Spirits 1.33 gallons, 92.88 ounces alcohol 

Malt liquors. 6.83 gallons, 34.97 ounces alcohol 

Total 8.16 gallons, 127.85 ounces alcohol 

1886— Spirits 1.26 gallons, 85.45 ounces alcohol 

Malt liquors. 11.20 gallons, 57.34 ounces alcohol 

Total 12.46 gallons, 142.79 ounces alcohol 

1896 — Spirits 1. 00 gallons, 67.84 ounces alcohol 

Malt liquors. 15.16 gallons, 77.62 ounces alcohol 

Total 16.16 gallons, 145.46 ounces alcohol 

Comparing the per capita consumption of 1876 and 
1886, there is an increase of a little more than 11.5 per cent 
in the total alcohol consumption, while a comparison of 
1886 with 1896 gives an increase of something less than 
2 per cent. It will thus be seen that the per capita con- 
sumption of absolute alcohol has increased about 14 per 
cent in twenty years. Taking the average yearly per 
capita consumption of the two decades, the showing is 
much less favorable. The former shows an average per 
capita consumption of spirits amounting to 1.306 gallons 
and the latter 1.336 gallons, an increase instead of a de- 
crease, of .03 gallon. The increase in the average per 
capita consumption of malt liquors during the same time 
was enormous. During the decade 1876-85 it was only 
8.57 gallons, while in the decade 1886-95 it was 13.82. 
Thus the per capita consumption of absolute alcohol aver- 
aged about 70 per cent more for the years of the second 
decade than for the years of the first decade. During this 
same time the per capita consumption of wine averaged, 
for the first decade, .465 gallon, and for the second, .459 
gallon annually, a decrease of only .006 gallon in the 
second decade. From these figures it will be seen that, 
while we still continue to drink our spirits and wine in 
practically the same amount that we did twenty years ago,. 



182 SHALL WE DRINK WINE ? 

we have enormously increased our annual supply of malt 
liquors, so those who think that the rapid increase in 
beer consumption is lessening the drink evil are laboring 
under a delusion. 

No doubt this enormous increase in the consumption 
of malt liquor is due to the old and carefully fostered error 
that beer is a harmless beverage, and that if beer could be 
substituted for potable liquids containing a larger percen- 
tage of alcohol, the cause of temperance would be prac- 
tically won. It is difficult to say how old this fraud may 
be. Away back in the colonial days of New England the 
brewing industry was fostered and encouraged by a law 
exempting from taxes and giving a prize to any brewer 
who should produce more than five hundred barrels of 
beer annually. In some parts of New England the sale 
of light alcoholic drinks is still favored by the law, requir- 
ing a much smaller license fee from saloons in which beer, 
wine, and cider only are sold. In Boston prior to 1886 
a license of $250 was required from sellers of these bev- 
erages, "it having been urged that it was in the interest 
of temperance to encourage the use of malt liquors and 
thereby decrease the consumption of distilled spirits" (The 
Liquor Problem, by the Committee of Fifty, P. 198). So 
we find on every hand not only laymen but physicians 
urging the encouraging of beer drinking as a temperance 
measure. A recent article by a medical man (Journal of 
the Am. Med. Assn., Feb. 19, 1898) contains the follow- 
ing statement : "In the writer's judgment it would be wise 
for the government to put upon the manufacture of spirits 
used as a beverage the highest excise duties compatible 
with collection, a moderate excise on fermented liquors 
derived from grain and hops, and to encourage the pro- 
duction of light table wines by leaving them free." 

For the refutation of this error, as in the case of all 



THE EFFECTS OF ALCOHOL ON CIVILIZATION. 183 

popular errors on medical subjects, we need only go to 
those men whose opinions are based upon exact methods 
of investigation. Kerr, quoting Dujardin-Baumetz and 
Audige, says (Alcoholism and Drug Habits) "the more 
concentrated the alcoholic liquor ingested the more intense 
the inflammation of tissue. At the same time an equal 
quantity of the potable alcohols will sooner exhibit their char- 
acteristic symptoms if largely diluted with water. All alco- 
hols are poisons. All alcoholic influence is the same in 
kind, varying only in degree. The common belief that 
there is no wine or beer, but only spirituous, inebriety is 
an error. Of the inebriates treated at the Dalrymple 
Home in England, eight per cent have been wine or beer 
drinkers." 

Says one of Germany's most eminent physicians in a 
recently published pamphlet (Dr. Adolph von Struempell, 
Ueber die Alkoholfrage vom aertztlichen Standpunkt aus, 
1898) "when we see year after year a not insignificant 
number of respected men, skillful in their calling, sicken 
and die when sickness and death certainly are chiefly or 
exclusively due to the supposedly innocent habit of drink- 
ing from two to three liters of beer daily, should it not be 
the earnest care of the physician to call attention to this 
dangerous habit?" Says the same author again (Loc. Cit, 
P. 15) "Nothing is from the physician's standpoint more 
false than to think that the evil influence of alcohol is 
lessened through the increased substitution of beer for the 
stronger alcoholic drinks." It is under the deceptive mask 
of a pleasant tasting and nutritious beverage, as beer, that 
alcohol finds its way into circles otherwise completely 
closed to it. 

Certainly another important fact cannot be too often 
reiterated. That is, that an overwhelming majority of all 
inebriates or drunkards begin their downward career with 



184 SHALL WE DRINK WINE ? 

beer and wine tippling. As a rule, the stronger alcoholic 
liquors are regularly indulged in only after a necessity or 
desire for alcoholic narcotism has been produced by the 
drinking of beverages containing smaller percentages of 
alcohol. When this stage in the tippler's career is reached, 
he no longer seeks to quench his thirst with a beverage, 
but to supply the demands of a depraved nervous system 
with its accustomed poison. 

Let no one, then, be cajoled into believing that the 
drinking of beer should be encouraged as a temperance 
measure ; for not only has the enormous increase in the per 
capita consumption of beer not lessened that of spirituous 
liquors, but, even should the former totally displace the 
latter, nothing would be gained unless the total per capita 
consumption of alcohol should be decreased. In short, we 
shall gain nothing for the welfare and advancement of 
civilization by substituting beer drunkards for whiskey 
drunkards. 

From an economic point of view the drink habit is 
ruinously expensive. Taking again the amount of alco- 
holic beverages consumed in the year 1896 we find the fol- 
lowing probable amount paid by the consumer: 

Spirits — 71,051,967 gallons at .50 per pint. . $284,207,868 
Wines — 18,701,406 gallons at .50 per quart. 37,402,812 
Malt liquors — 1,080,626,164 gal. .10 per pint 944,500,931 



Total $1,266,111,611 

This estimate is probably too low. Sold over the bar 
of the saloonkeeper, the average drink of spirits is perhaps 
not more than one and a half ounces, which sells at an 
average price of ten cents. This would make a pint sell 
for something more than a dollar, making no allowance 
for the almost universal adulteration with water after it 



THE EFFECTS OF ALCOHOL ON CIVILIZATION. 185 

reaches the hands of the saloonkeeper. Much beer and 
wine, as well as spirits, is bought in bulk by the customer 
at figures lower than those given here, but there is to offset 
this the higher price paid in the public houses where the 
greater part of these beverages is consumed. Taken alto- 
gether, the total amount spent by the customers cannot 
be less than that here indicated; 1,266 millions of dol- 
lars is an enormous sum of money. It is about equal to 
one-half of the nation's greatest public debt. It is one 
and a quarter times the indemnity paid to Germany by 
France at the close of the Franco-Prussian war. It is 
more than one-half the total money now in circulation in 
the United States. So great is the amount of wealth rep- 
resented by these figures that it would have sufficed to 
pay more than one-half the wages of all the factory em- 
ployes of the United States in the year 1890. And what 
does the consumer get for this sum of money? A very 
small amount of food material mixed with a relatively 
large amount of poison. The food material, if it were 
separated from the other ingredients, would be dear at 
one-twentieth of that which was paid for the beverages, 
but, as a matter of fact, its value, small as it was, was 
entirely destroyed by the admixture of the poison. *We 
are now engaged in a costly war with Spain. Our ex- 
penses may amount to anywhere from six hundred to a 
thousand million dollars before it is ended. Economical 
citizens mention this great sum and groan at the pros- 
pective burden of taxation. But by this war we shall 
gain honor, respect, and a magnificent national solidarity, 
which will make those millions a profitable investment, and 
the burden of investment will rest lightly upon the 
shoulders of a prosperous and happy people. Let us 

*This was written in the summer of 1898. As a matter of fact our expenses in the 
war with Spain were only about one-fifth of the amount paid for alcohol beverages In 
1896, and we have gained all the advantages mentioned here, and more. 



186 SHALL WE DRINK WINE ? 

rather turn our attention to twice that great number of 
millions, which is a self-imposed burden upon the 
shoulders of a few millions of people and brings no return 
but poverty, misery, sickness, and death. 

Of peculiar interest is the fact that three-fourths of the 
total amount spent for alcoholic beverages went for malt 
liquor, nearly all of which was domestic beer. This 
means, of course, that the workingman paid the largest 
part of this enormous saloon bill, for he is by far the 
most important consumer of beer. For this purpose he 
spends a considerable part of his income. Here in Amer- 
ica, among the workingmen of cities at least, it cannot be 
less than ten per cent. Perhaps fifteen or sixteen per 
cent would be nearer the truth. Of the amount thus spent 
in Germany, Von Struempell says (Die Alkoholfrage, P. 5) 
"I have through thorough inquiry very often convinced 
myself that the laborer who receives three marks daily for 
his services spends fifty pfennigs for beer for his own use, 
that is, about one-sixth of his entire income." With us 
wages are higher and the necessities of life cheaper, con- 
sequently there is an incentive to spend more for beer. 
Certainly an amount is thus spent sufficient, if it were 
invested in dividend paying life insurance or some other 
form of accumulating investment, to guard against all the 
ordinary exigencies of misfortune and prevent the work- 
ingman and his children from ever becoming public 
charges. 

But human lives and money are not the only forms of 
wealth which are sacrificed to alcohol. The amount of 
human effort which is dissipated in the production, dis- 
tribution, and consumption of alcoholic beverages is sim- 
ply incalculable, and it is as absolutely thrown away as 
though the individuals who manufacture and distribute 
them and those who spend their time in drinking them 



THE EFFECTS OF ALCOHOL ON CIVILIZATION. 187 

and waiting- for the paralyzing effects of alcohol to be dis- 
sipated were members of a standing army quartered upon 
the people. Alcoholic beverages possess no economic 
value aside from the small amount of food material found 
in malt liquors and wines. It should be remembered, 
however, that the grain and fruit used in the production 
of these has many times the value of the manufactured 
articles, while that used in making distilled liquors is a 
total loss as food for human beings. 

The size of this army, which were better idle, is not 
easily estimated. The census of 1890 gives 50,000 as the 
number engaged in brewing alone. Probably there are 
at least as many more engaged in the manufacture of 
distilled spirits and wine. How many are directly engaged 
in the liquor traffic? As no statistics are at hand, the 
number can only be estimated. If there is one saloon for 
every five hundred inhabitants (and this estimate is not 
too high) we have about 140,000 saloons, the care of 
which occupies the whole time of at least 200,000 men. 
But beside the saloonkeeper there are others engaged in 
the liquor traffic, wholesalers, traveling salesmen, and the 
like, to the extent of at least 30,000 men. By far the great- 
est loss of time, however, is that suffered by the consumer, 
and it is more difficult to estimate. An interesting attempt 
in this direction was made by the Committee of Fifty last 
year in Boston. Here 606 saloons received in the aggre- 
gate 226,752 visits daily. Suppose that each visit con- 
sumed ten minutes of time. Then there was spent in the 
saloons of Boston 37,792 hours each day, equal to the 
idleness of 3,779 men, allowing ten hours for a working 
day. Boston has a population of about a half million. 
At the same rate of time expenditure, the whole United 
States has an army of over 500,000, nearly all adult males, 
spending all their time in drinking alcoholic beverages. 



188 SHALL WE DRINK WINE? 

It may be objected that much of this time is given outside 
of working hours. This is true, but it should also be 
remembered that the mere time spent in drinking is not 
the only factor of loss, perhaps not even the most im- 
portant one. There still remains to be considered the 
time actually lost by incapacity for labor, brought about 
not only by acute alcoholic poisoning, but also by the 
scores of physical ailments thus engendered, which lessen 
or completely destroy the productive capabilities of the 
drinkers, and these would, without doubt, much more 
than offset the time spent outside of working hours. 

To sum up, then, the army devoted to the interests of 
alcoholic beverages is made up as follows: 

Manufacturers 100,000 

Wholesalers and traveling salesmen 30,000 

Retailers 200,000 

Drinkers 500,000 

Total 830,000 

This estimate, then, gives us an army approximating 
a million men who contribute nothing of economic value 
to the nation and who are supported by the productive in- 
dustries, a number equal to about six per cent of the 
adult male population. 

But the expense does not stop here. There is still to 
be considered the enormously costly machinery of legal 
procedure made necessary by the increase in crime which 
is directly traceable to brain deterioration resulting from 
alcoholic intoxication, asylums for dependent children, 
pauper institutions, insane asylums, and prisons, all of 
which are so largely recruited from the ranks of drunk- 
ards and their descendants, making altogether an expense 
which must consume the product of many hundred thou- 



THE EFFECTS OF ALCOHOL ON CIVILIZATION. 189 

sand individuals. Would it be too much to say that at 
least ten per cent of our industrial efforts are completely 
neutralized by the pernicious habit of alcohol drinking? 

The increase in alcohol consumption in European 
countries is a matter of grave importance. In Germany 
for the years 1872 to 1875 there was an average per 
capita consumption of 67.3 liters of beer and 8.6 liters of 
spirits. This amount increased in the next five years un- 
til in 1 88 1 the consumption of beer was 87.6 and of 
' spirits 9.2 liters per capita. In Prussia alone in 1872, 57.4 
liters of beer and 12. liters of spirits was the per capita 
consumption. In 1875 the amount had risen to 60.3 
liters of beer and 14.9 liters of spirits per capita. The 
increase in the number of saloons has kept even pace with 
the increase in consumption (August Smith, Die Alkohol- 
frage, P. 107). The per capita consumption of alcoholic 
beverages for all the German Empire in 1896 was accord- 
ing to Bade as follows: Beer 108.5 liters, spirits 13.2, 
and wine 6.44 liters. A liter is 2.1 13 pints. Estimating 
a liter at one quart, the per capita consumption in gallons 
would be, approximately, beer 27.1 gallons, spirits 3.3 
gallons, and wine 1.61 gallons, more than twice as great 
as the per capita consumption in America, estimated as 
absolute alcohol. 

The amount of illness and death for which alcohol is 
responsible is well set forth in statistics gathered by Dr. 
Smith. In Switzerland, during the last few years, the 
name and cause of the disease producing death in every 
case is given on a death card filled out by the attending 
physician, without giving the name of the patient. From 
these, tolerably correct reports of the percentage of deaths 
from alcohol have been obtained. The result of these 
statistics for the years 1891 and 1892, for the fifteen largest 
cities of Switzerland give the following: Of all males 



190 SHALL WE DRINK WINE? 

of 20 years of age or over dying in 1891, 10.7 per cent 
and in 1892, 10.8 per cent, died of alcohol poisoning. In 
the same years the percentage of females dying from the 
same cause was 1.7 and 2 per cent, respectively. 

Because of the similar ways of living, and especially 
of the rapid increase in spirits consumption in the prov- 
inces of Posen and Schlesien, the result in Germany, 
thinks Smith, is at least as bad as that in Switzerland, 
and probably the death rate is higher. That is, every ninth 
individual in Germany dies of alcoholic poisoning. 

If it be objected that these statistics are insufficient and 
that the number of deaths from alcoholism in these two 
years was accidental and not to be considered the average 
for any considerable time, attention is called for further 
proof to the mortality statistics, against which these objec- 
tions cannot be urged, of certain life insurance companies. 
In some English insurance companies the total abstainers 
are put in a separate class and receive more favorable 
rates than the moderate drinkers. Here it has been 
found that the death rate of the total abstainers is about 
30 per cent less than that of those who are classed as 
occasional or moderate drinkers. Taking the statistics 
of the "United Kingdom Temperance and General Provi- 
dent Institution" in the years 1886 to 1891 : 

Unclassified Abstinence Class 

Estimated deaths 7,7&3 5> T 77 

Actual deaths 7,459 3,663 

That is, the actual number of deaths in the occasional 
drinkers was 97.33% of the expectation, while the actual 
number in the abstinence class was only 70.75% of the 
expectation. 

Still more convincing is the showing of the statistics 
for 1884 to 1889 of the "Scepter/' the clients of which are 



THE EFFECTS OF ALCOHOL ON CIVILIZATION. 191 

mostly ministers of the gospel and members of various 
religious orders, which is as follows: 

Unclassified Abstinence Class 

Expected deaths 569 240 

Actual deaths 434 143 

Here the actual deaths of the first class were 76.27% 
of the expectation, and of the second class only 57.42%. 

In the year 1893, in the former company, the deaths 
reached 100, 85% of the expectation, in the unclassified, 
while among the abstinence class it was only 71.62% of 
the expectation. In the latter company the results cor- 
respond with those of the former. In consequence of the 
favorable showing in the death rate of the total abstainers 
these companies give them a discount of 8 or 10% on 
their premiums, and notwithstanding this discrimination: 
they are better risks than the unclassified. 

Returning to the mortality statistics of Switzerland 
as exhibited by the death cards already referred to, the 
influence of alcohol is as perceptible as in those of the 
insurance companies. Taking the mortality of all males 
over twenty years of age by twenty year periods and 
comparing the number of deaths from alcohol with the 
whole number, the following table is the result: 

Total Deaths. Deaths from Alcohol. 

1891 3499 366 

1892 3343 r 361 

Ages 20-39 40-59 Over 60 20-39 40-59 Over 60 

1891 27 % 36.3% 36.7% j 29.2% 50 % 20.6% 

1892 25.5% 38.3% 36.3% I 22.7% 55.7% 21.6%, 

Analyzing the above table, it will be seen that while 
the first group shows practically the same percentage of 
mortality in deaths from alcohol as is shown in the total 
number of deaths, in the second group the percentage 



192 SHALL WE DRINK WINE ? 

of mortality in the subjects of alcoholism is enormously 
increased. This is undoubtedly due to the fact that the 
first period is given to preparing a way, through degen- 
eration processes, for rapid dissolution after the fortieth 
year, from tuberculosis and other masked diseases. Thus 
at the very time of life when the man is of greatest value 
to his family and to the state he is destroyed by a system 
of chronic alcoholic suicide. 

The influence of moderate drinking in the production 
of increased morbidity is well illustrated by the statistics 
collected by Carpenter relating to British soldiers in the 
Indian service. Observations were made upon 17,354 
moderate drinkers and 9,340 abstinent soldiers. Of the 
former group one out of every 7.28 men was sent to the 
hospital, but of the latter group only one out of every 14.47. 
Still more favorable to the abstinence group are the sta- 
tistics considering the average number of days spent in 
the hospital. The average number of sick days of every 
hundred moderate drinkers was 10.20, while the average 
of the abstainers was 3.64 sick days for every hundred. 

The experience of certain benefit associations in Eng- 
land gives very similar results. In three of these (Mutual 
Experience Rural Towns and City Districts, Mutual Ex- 
perience Rural Districts, and Foresters), in the five years, 
1884 to 1889, f° r eacn laborer, there were 26.20, 24.68, 
and 2y.66 weeks of illness, an average of 26.18 weeks 
while at the same time in the "Sons of Temperance," 
which receives only total abstainers, the number of weeks 
of illness for every member was only 7.48, less than one- 
third of the others. 

Here we have a remarkably close agreement between 
statistics taken from widely separated communities and 
under very different circumstances, and from them it 
would appear that two-thirds of the total amount of illness 



THE EFFECTS OF ALCOHOL ON CIVILIZATION. 193 

is to be ascribed to alcohol alone. Moreover, it is evident, 
and practical experience long ago established, that alco- 
holic indulgence is able to make otherwise trifling illness 
serious, short illness long, and cause a fatal issue in seri- 
ous cases which might otherwise have recovered. 

Another way in which civilization is affected by alco- 
hol is the amount of crime for which it is directly respon- 
sible. To adequately discuss the relationship of alcohol- 
ism and crime would require much more space than can 
be given to it in a work of this kind. Nothing more will 
be done here, therefore, than to indicate the probable per- 
centage of criminal acts for which alcohol is directly re- 
sponsible. Statistics on this subject should not be taken 
too implicitly. As information regarding previous habits 
of the criminal generally come from the crminal himself, 
they are not always trustworthy. With a view of obtain- 
ing a light sentence or an early pardon, the prisoner is 
liable to hide much of the truth regarding his habits, and 
put himself in as favorable a light as possible before the 
public. On the other hand, the criminal often seeks to 
excuse his conduct by untruthfully asserting that he was 
drunk at the time the crime was committed. 

Some statistics may be produced, however, which 
fairly show how much crime may be directly attributed to 
alcohol drinking, both in America and Europe. The 
most complete statistics yet compiled in America upon 
this subject are those embraced in the Twenty-sixth Annual 
Report of the Bureau of Statistics of Labor of Massa- 
chusetts, for the year ending August 20, 1895. During 
this time there were accomplished, within the state, 26,672 
convictions, 17,573 of which were for drunkenness alone, 
and 650 for drunkenness united with other crimes. Elim- 
inating the convictions for drunkeness and for drunkenness 
with other crimes, there remain 8,449 convictions for other 



194 SHALL WE DRINK WINE? 

crimes to be investigated. Of this number, from nine 
only was no information obtained as to whether the con- 
vict was under the influence of liquor at the time the 
crime was committed. Of the remaining 8,440, an affirm- 
ative answer was given in 3,640 cases, and in 4,791 cases 
the convict replied that he was not under the influence 
of alcohol at the time that the crime was committed. In 
other words, out of the total number of convictions 68.73% 
were directly due to drunkenness or to drunkenness with 
other crimes, and 81.97% of the criminal convictions were 
for criminal acts committed while the convict was under 
the influence of alcohol, leaving only 18.03% °f au " tne 
convictions not directly traceable to alcoholic intoxication. 
Examining the convictions for crimes against persons 
we obtain the following results: For murder and man- 
slaughter there were 21 convictions, and 12 of the offenses, 
or 57%, were committed while the convict was under the 
influence of alcohol; 61 cases of assault with a weapon, 
31 of which were due to alcohol; 69 cases of assault upon 
an officer, with 36 due to alcoholic intoxication; 12 cases 
of felonious assault, 3 of which were committed under 
the influence of alcohol; and 1,652 cases of assault and 
battery, of which 985 were influenced by alcoholic intoxi- 
cation. For robbery there were 46 convictions, 38 of 
which were committed by men under the influence of 
liquor. It will thus be seen that about 50% of the cases 
of serious assault, 67% of the cases of assault and bat- 
tery, and 82% of the cases of conviction for highway rob- 
bery, were for offenses committed while the criminal was 
under the influence of alcoholic intoxication. Of crimes 
against property, 1,137 persons out of a total number of 
2,107 convicted of larceny, or nearly 54%, were under 
the influence of alcoholic drink at the time the offense 
was committed, and of incendiarism and malicious mis- 



FIG. 4. 

RELATION OF DRUNKENNESS TO CRIME. 
Penitentiaries for Men. 



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Drunkenness. 



Intermittent 
Drunkards. 



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NOTE— The black column represents the total percentage of 
crime caused by drunkenness. The other two columns represent 
the relative amount of alcoholic crime committed by the intermittent 
and habitual drunkard respectively. 



FIG. 5. 



Houses of Correction for Men. 



TOO 

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sisting States 
Authority. 

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mestic Peace. 


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ounterfeiting. 


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ublic Peace. 


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NOTE — The black column represents the total percentage of 
crime caused by drunkenness. The other two columns represent 
the relative amount of alcoholic crime committed by the intermittent 
and habitual drunkard respectively. 



THE EFFECTS OF ALCOHOL ON CIVILIZATION. 195 

chief, 33% and 66% respectively were to be attributed to 
alcoholic intoxication. 

On the other hand, crimes against the authority of the 
state, like fraud, embezzlement, selling liquor without a 
license, counterfeiting, polygamy — crimes unaccompanied 
by personal violence — were not committed as a rule by 
drunkards, the percentages being 7, 28, 14, o and 26 re- 
spectively. 

Very similar were the results obtained by Baer and 
reported at an international prison congress in 1874. The 
report covered 120 prisons and houses of correction which 
contained 32,837 male convicts. Of this number, 13,706 
attributed their criminal career directly to the influence 
of alcohol. Two classes of penal institutions were inves- 
tigated — jails, houses of correction, and similar prisons, 
and penitentiaries — and a separate report made for each 
class. The convicts were classified according to the 
nature of the crime committed, and, furthermore, divided 
into occasional and habitual drunkards. The following 
tables (Figs. 4 and 5) arranged by Dr. August Smith of 
Baden (Die Alkoholfrage, P. 9) show at a glance the per- 
centage of drunken criminals as compared with the whole 
number in each class of criminal offenses, and also the 
relative number of occasional and habitual drunkards 
among the convicts addicted to alcoholic intoxication. Of 
the 13,706 convicts given to alcoholic excesses, 7,262 were 
periodic or occasional drunkards, while 6,437 were habitual 
drunkards. 

It will be seen from Dr. Smith's table that 46.1% of 
the cases of murder and 63.2% of the cases of man- 
slaughter were influenced by alcoholic intoxication, giv- 
ing an average of 54.1% for the total homicides, differing 
only by 3% from the result obtained in Massachusetts. 
Further comparison between the two groups of statistics 
shows a like similarity throughout. Take, for instance, 



196 SHALL WE DRINK WINE ? 

assault with intent to kill or do great bodily harm, assault 
and battery, and robbery and highway robbery. The 
Massachusetts statistics give 50%, 67%, and 82%, while 
Dr. Smith's tables give 50.8%, 68.4% (63.4% in table 
I and 74.5 in table II), and 68.8% respectively, as having 
been directly caused by alcoholic intoxication. A com- 
parison of all the other crimes in the two groups of sta- 
tistics show very closely approximating results. It 
should not be forgotten, however, that the Massachusetts 
statistics are based upon the question as to whether the 
convict was under the influence of alcohol at the time the 
offense was committed, while those collected by Baer are 
based upon the convicts drinking habits as a whole, with- 
out regard to his condition at the particular time the crime 
was actually committed. This fact is sufficient to account 
for the differences in percentages of those crimes which 
are not accompanied by violence. Crimes like embezzle- 
ment, fraud, and counterfeiting have been initiated by 
necessity arising from the wastefulness of drinking habits, 
but the crimes themselves could scarcely be successfully 
carried out by one under the influence of alcohol. 

An important part is played in criminal statistics by 
the occasional or periodic drunkard. In all deeds of vio- 
lence he has won a bad eminence, and his moral degen- 
eration, his insensibility to public decency and morality, 
is scarcely less marked. It is seen from Baer's statistics 
that of all the deeds of violence for which alcohol can be 
held directly responsible the occasional drunkard com- 
mitted 58.6% of the homicides, 60.9% of the attempts to 
kill, 72.7% and 81.4% of the assaults with injury, 89% of 
the cases of resistance to the state's authority, 94.2% of 
breach of domestic peace, and 73.3% of the offenses 
against public morals. Indeed, the statistics show just 
what ought to be expected, and just what is happening 



FIG. 6. 



Sunday 




Mights 
Tuesday 



Table showing the relative number of crimes against persons on 
the different days of the week, and on the nights of Tuesday to Friday 
inclusive j for which conviction was secured in the court of Judge Lang 
(adopted from A. Smith's " Die Alkoholfrage"). 



THE EFFECTS OF ALCOHOL ON CIVILIZATION. 197 

in the daily experience of all peoples who drink alcoholic 
beverages — namely, that a sudden access of alcoholic 
intoxication produces a species of mania characterized, 
usually, by homicidal tendencies. Moreover, if statistics 
were collected concerning' the crimes of habitual drunk- 
ards, they would certainly show that most of them were 
also brought about by the same kind of mania due to an 
imbibition of an increased quantity of alcohol. 

An interesting investigation showing the connection 
of alcoholism and crime was made by Judge Lang of 
Zurich in 1890. The statistics collected by him showed 
that acts of violence against persons and property were 
committed mostly between Saturday evening and Monday 
evening, and that this increase was coincident with an 
increase in alcoholic consumption. The following dia- 
gram (Fig. 6) shows the relative proportion of cases of 
assault with bodily injury for the different days of the 
week, and for Tuesday, Wednesday, Thursday, and Fri- 
day nights. Of 141 convictions for this offense, only 
41 were committed "on the 208 days of the year on which, 
according to a ruling custom, less is drunk" than during 
other times. The other 100 offenses were committed on 
the 157 days upon which an increased amount of alcohol 
was consumed, and of the 41 convictions above men- 
tioned, 25 were for offenses committed in or near a saloon 
at night, while in only 16 cases was there no evidence 
that alcohol had anything to do with the crime. 

Said Lord Coleridge of England: "If the English 
people could be made temperate nine-tenths of the Eng- 
lish prisons could be closed." 

Said Dr. Krohne, director of penal institutions in Ger- 
many, in a public address delivered a few years ago : "Of 
crimes against life and limb, assault, assault with bodily 
injury, manslaughter, and attempts to commit murder 



198 SHALL WE DRINK WINE? 

nearly the entire number is chargeable to drunkenness. 
Crimes against property are almost without exception the 
result of necessity, and in 80% of the cases the necessity 
which led to the crime is the result of drunkenness. 
Crimes against morality are almost exclusively caused by 
alcoholic beverages. This has been my experience in a 
service of twenty years in Oldenburg, Schleswig-Holstein, 
Hesse, and Brandenburg. Seventy per cent of all deeds 
of violence against property rights are, more or less, the 
result of alcohol drinking. Two years ago I received a 
visit from a friend who had just served as a juryman in 
Wuerzburg, and he remarked that it was a significant 
fact that every crime which had been tried during his 
service was the result, direct or indirect, of alcoholic intox- 
ication." 

Think, too, the extent to which the habit of alcoholic 
intoxication prevents the highest realization of physical 
and mental capability and the nation's loss arising there- 
from. Said a recent well-known writer on economic sub- 
jects (Walter A. Wyckoff in "The Workers") : 

"Men .... who have risen by force of ambi- 
tion and sheer development of manual skill to good posi- 
tion in the factory and have there stood still, their con- 
genital qualities incapable, presumably of higher efficiency. 
But sadder far than theirs is the case of men who are 
often best endowed with native cleverness and aptitude, 
who rise quickly in the scale of promotion, and who might 
rise far higher than they do but for the cause of careless 
living. They know no interest in their work nor pleas- 
ure in its doing. To them it is the sordid drudgery by 
which they gain the means of gratifying their real pur- 
pose and desires. With sullen perseverance they endure 
the torment of labor, with pay day in view and then Sat- 
urday night and Sunday spend all in their mad revels in 
what they call life." 



THE EFFECTS OF ALCOHOL ON CIVILIZATION. 199 

But over and above all, and far more important than 
all the material losses chargeable to the universal imbibi- 
tion of beverages poisoned with alcohol, has been the 
effect which alcohol has had upon the ethics of civilization, 
upon the ideals and conduct of man in his intercourse 
with his fellows. These alcohol has immeasurably low- 
ered. All classes and phases of society have suffered 
thereby. In the family, where the breadwinner should 
also give love and protection to the weak members of 
society and carefully train them in the duties and respon- 
sibilities of adult life, it causes brutality, neglect, and a 
never ending round of untold squalor and misery. The 
sum total of human suffering caused by drunken parents 
is immeasurable. Certainly it is more than that arising 
from all other causes combined. The army of individuals 
reared under such circumstances are savages real as any 
with which our soldiers on the frontier ever had to deal; 
but they are savages of a lower type than those. They 
are constantly at war with the better interests of human- 
ity as exemplified in a progressive, civilized society, for 
they respect neither personal nor property rights. 

Not through drunkenness alone, as that term is popu- 
larly understood, but also through "moderate drinking" 
is the average moral tone, the average capability for exer- 
cising the subtlest mental processes through which fine 
distinctions of right and wrong conduct are determined, 
immeasurably lowered. The human brain, through 
countless centuries of evolutionary progress has acquired 
a fineness of texture, a sensitiveness to external impres- 
sions and a corresponding swiftness of function, which 
make it the most powerful and at the same time the most 
easily injured of all animal organs. It is just upon this 
fineness of brain texture that civilization depends for the 
carrying out of her highest aims and purposes, for the 



200 SHALL WE DRINK WINE? 

solution of the manifold and complicated problems which 
social progress is bringing forth on every hand; and it 
is this same fineness of brain texture that is destroyed 
or rendered impossible of development under the influ- 
ence of even "moderate'' quantities of alcohol daily in- 
gested. 

To the individual no less than to the state are the irri- 
tating and stupefying effects of alcohol an irreparable loss. 
The same degree of brain development which makes the 
citizen's voice and conduct of such value to the state also 
renders him capable of enjoying the greatest degree of 
human happiness, a healthy enjoyment of the purely phys- 
ical pleasures of life and that exquisite happiness born of 
a healthy contemplation of the subtleties of natural phe- 
nomena, of the development of human progress as ex- 
hibited in history, the intricacies of mechanical problems, 
or any other department of human knowledge which may 
especially engage his attention. All of these are a mental 
Terra Incognita to the man who daily takes his measure 
of alcoholic beverage, even though it may never be suffi- 
cient to make him noticeably drunk. Civilization, more- 
over, suffers immeasurable loss through the corrupting 
influence of the liquor traffic upon the affairs of govern- 
ment. So widespread and intricate is its contamination 
in this respect that nearly every great municipality in our 
country has been compelled to recognize it as a power, 
and protect it in its destructive and corrupting business. 
In many instances it has succeeded in getting entire con- 
trol of the affairs of government, and these cases have 
always been attended by retrogression and disaster to 
human progress. 

Alcohol exerts its corrupting influence beyond those 
who drink it. Its evils act as examples to corrupt the 
impressionable of all classes. The saloon attracts not 



THE EFFECTS OF ALCOHOL ON CIVILIZATION. 201 

only those who are inclined to drink, but all kinds and 
grades of evildoers. It is as truly the pest spot for the 
development of crime as is the sewage contaminated well 
the source of typhoid fever. Is a murder, a highway rob- 
bery, a burglary, to be committed, it is almost always 
planned in a private room of a saloon. So are the num- 
berless petty crimes by organized gangs of human vultures 
who prey upon the industrious public. 

In short, the universal consumption of these alco- 
holic poisons render impossible the realization of civiliza- 
tion's highest ideals. It does this because it destroys a 
vast number of useful lives, renders many more physically 
incompetent through disease, destroys an immense amount 
of valuable brain matter annually, increases insanity, incurs 
the expense of supporting a vast army of non-producers, 
immeasurably increases crime, brings unhappiness, pov- 
erty, and misery to millions, and causes a corrupt admin- 
istration of the affairs of government. I firmly believe 
that we have in this great country of ours a system of 
government, natural resources, and a people of the kind to 
give to the world in fifty years, if the production and 
importation of alcoholic beverages were absolutely pro- 
hibited, a people that for beauty, strength, virtue, mate- 
rial wealth, and happiness would equal the fondest dreams 
of a Millennium. 



XX, 

<Hbat is the Best Method of Dealing with the 
Hlcobolic Question. 



It is not the purpose of this work to give even a brief 
history of the various temperance and prohibition move- 
ments which have been inaugurated from time to time, 
both in Europe and in America, to abate the evils of alco- 
holic poisoning. All of the movements have received 
attention by other writers; and especially have the legis- 
lative aspects of the liquor problem in America received 
adequate treatment in a carefully prepared volume by Dr. 
F. H. Wines and Mr. John Koven, of the "Committee of 
Fifty" (The Liquor Problem in Its Legislative Aspects, 
by F. H. Wines and John Koven, 1897). The general 
statement may be made that all temperance movements, 
whether lay, religious, or legislative, have accomplished 
some good; but sometimes the amount of good accom- 
plished has been very small compared with the efforts put 
forth; and it has oftentimes seemed that the same amount 
of effort applied in a different direction might have been 
productive of greater results. 

Particularly interesting and instructive has been the 
inauguration of legislative prohibition and governmental 
control of the liquor traffic, by giving the state the sole 
right of dispensing alcoholic liquors. The history of all 
legislative prohibition shows that while the real prohi- 
bition which the law sought to attain has never yet actually 
been accomplished, the enactment of all prohibitory laws 



BEST METHOD OF SUPPRESSING ALCOHOL. 203 

has been attended by some measure of good, the amount 
being in exact ratio with the fidelity with which the laws 
were enforced. Where public opinion has been in favor 
of their enforcement a practical degree of prohibition has 
been attained; but public opinion is unstable, and the 
community which is earnest in its desire for a total supres- 
sion of the liquor traffic this year may not be of the same 
opinion next year; so the prohibitory laws are contra- 
vened with impunity and fall into disrepute. In many 
communities in which the state has assumed the functions 
of the liquor dispenser a notable improvement in public 
morals has resulted. This improvement has been due to 
the fact that the cupidity of the saloonkeeper, who seeks 
by every means in his power to sell as much as possible, 
is removed, liquor being dispensed only in a certain quan- 
tity and not at all to any one who has the reputation of 
being a drunkard. Moreover, the officials in charge of 
the state dispensaries, having no interest in the sale of the 
liquor, and their terms of office depending upon the fidelity 
with which the laws regulating the sale are carried out, they 
attend strictly and faithfully to all the legal details which 
rob the traffic as far as possible of its evil influences. 
Moreover, the state dispensary system has decreased the 
number of saloons, in some communities entirely abolish- 
ing them, decreasing in the same degree their corrupting 
influences; and the one dispensary which has displaced 
the many saloons is a model of decency compared with 
the average saloon. The dispensary, too, does a great 
deal for abstinence in making social drinking impossible. 
The man who patronizes the dispensary gets the poison 
for his own consumption, so that only one person is 
injured thereby. If he patronizes a saloon, the chances 
are many to one that his social instincts would cause at 
least another person to indulge who would not have done 



204 SHALL WE DRINK WINE? 

so otherwise. It is likely, too, that the moral teachings 
of the dispensary may be of value to boys and young men. 
An institution around which the state has fixed so many 
limitations must appeal to the intelligence of the average 
youth as being an evil. Certainly alcohol under such 
restrictions has none of the charm which attends its sale 
in the midst of gay company, with games and music, and 
surrounded by the expensive lavishness of fine furniture, 
cut glass, and the other attractions which give to the liquor 
traffic its greatest fascination, and an appearance of well 
being and cleanliness which it little deserves. 

The value of the dispensary system in comparison with 
laws totally prohibiting all traffic in alcoholic beverages 
is well illustrated in the experience of Sweden with the 
well-known "Gothenburg system." The system was 
named from the town in which it was first inaugurated, in 
1 87 1. The beneficial effects of this method of dealing 
with the alcohol question are seen in the results obtained. 
In 1 89 1 there were only 304 places in the entire country 
where spirits could be bought, that is, one place to every 
6,600 inhabitants ; and the per capita consumption of abso- 
lute alcohol fell from the enormous quantity of 8 liters, or 
over two gallons, to 1.8 liters. In 1890, however, a new law 
was passed which was much more stringent in its opera- 
tions than the one it superseded. It completely abolished 
the still existing small private sale of liquor, and almost 
suppressed the sale of spirits in the entire country; for- 
bade among other things all sale of liquor from one o'clock 
Saturday afternoon until eight o'clock Monday morning, 
and on all other days of the week before eight o'clock in 
the morning. Moreover, it gave local option to the 
cities, the inhabitants having the power to decide by bal- 
lot whether they would continue under the state dispensary 
system or have total prohibition. All persons, whether 



BEST METHOD OF SUPPRESSING ALCOHOL. 205 

male or female, over twenty-five years of age were enti- 
tled to vote on the question. In fourteen cities the result 
was for total prohibition, the women by the earnestness 
with which they carried on the campaign contributing 
much to the result. 

The experiment of prohibition in Sweden has, how- 
ever, not been a success. No sooner did it become impos- 
sible to purchase spirits openly than was an illicit trade 
begun ; in spite of the efforts of the authorities, those who 
wished to purchase alcoholic liquors found some way of 
doing so. Liquors were surreptitiously brought into the 
territory from which they had by popular voice been 
expelled and small stills were erected in many places for 
their manufacture. Indeed, the demoralization engen- 
dered by the unlawful traffic has been so great that many 
cities which had voted for prohibition have returned or 
contemplate returning to the restricted traffic under the 
dispensary system. 

It will thus be seen that attempts to entirely suppress 
all trade in spirituous liquors has been attended by the 
same results in Sweden as those with which we are famil- 
iar in America. 

Perhaps the greatest hindrance to the total suppression 
of commercial traffic in alcoholic liquors is the power of 
the invested capital engaged in their production. At the 
present time over four hundred million dollars are in- 
vested in the breweries of the United States alone. Cer- 
tainly as much more is engaged in the production of 
spirits and wine. Add to this the value of the land which 
is constantly engaged in supplying grain and fruit as raw 
material to the beverage manufacturing establishments and 
the amout of capital engaged, directly or indirectly, must 
be considerably more than one thousand million dollars. 
The value of the annual product of the breweries, based 



206 SHALL WE DRINK WINE ? 

on the estimates for 1895, is not less than two hundred 
million dollars, and of spirits and wine not less than one 
hundred million dollars' worth are sold annually. Thus 
the products of the breweries, distilleries, and wine presses 
for 1895 had a wholesale value of more than three hundred 
million dollars, while the combined value of the wheat and 
corn crops of that year was only two hundred thirty-seven 
million dollars. 

Moreover, the capital invested in the production of 
alcoholic beverages is more active and aggressive than 
that interested in the carrying on of any other enterprise. 
Not only do individual brewers and distillers have to meet 
the ordinary competition of others in the same business, 
but they constantly keep at work some political force 
such as will enable them to influence legislation favorable 
to their cause. The extent of the brewers' influence in 
some municipalities probably outweighs the combined 
influence of the rest of the citizens. Certainly it is suffi- 
cient to determine the direction of alcohol legislation. 
Speaking of this state of affairs in the city of St. Louis the 
authors of 'The Liquor Problem in Its Legislative As- 
pects" make the following statement (Pp. 331 and 332): 
"The multiplication of dram shops is largely due to the 
business rivalry between breweries, of which St. Louis has 
twenty-five or thirty, some of them among the largest in 
the United States, if not in the world. Three-fourths at 
least of the saloons are indirectly owned and operated by 
the breweries, which advance the license tax and collect 
it in installments by charging eight dollars a barrel for 
beer instead of six." In the city of Boston a similar state 
of affairs exists. Quoting from the same book (P. 192) 
we find that: "The small liquor shop keepers were 
controlled by their bondsmen, largely brewers and whole- 
sale dealers, and readily did the bidding of the latter for 



BEST METHOD OF SUPPRESSING ALCOHOL. 207 

the protection enjoyed or from necessity. In fact, the 
liquor power at this time was virtually a few men's power. 
In 1894, for instance, twenty-five wholesale dealers were 
sureties for 1,030 saloonkeepers. Three brewers were on 
328 bonds, another was on 112, others on from 8 to 109 
each. Twenty-five men thus had assumed a monied lia- 
bility of $2,660,000, some of them a liability in excess of 
the value of their property." 

In Chicago, Milwaukee, and other large centers of 
population the influence of the brewer, distiller, and whole- 
saler is similarly exerted. 

It is seen, therefore, that the enormous capital con- 
cerned in manufacturing alcoholic beverages exerts its 
whole influence along such lines as will tend to promote 
the sale of its products and prevent interference on the 
part of municipal authorities by keeping an army of de- 
pendents which efficiently checks all projected unfavorable 
legislation. 

To meet and overcome the aggressive energy of the 
makers and dispensers of alcoholic liquors, needs first of 
all a proper education on the part of the people. Some- 
thing of the kind is now going on with the children in 
the public schools, and undoubtedly much good is being 
accomplished thereby; but the system has many faults. 
The nature of the information thus imparted is often inac- 
curate and exaggerated. Recently a so-called ' 'health 
primer" was brought to the writer's notice, which exempli- 
fied this faulty teaching. It was a "popular" treatise on 
physiology, inaccurate in its statements, unattractive in its 
style of expression, and the subject of alcohol was dragged 
in at the end of each lesson, in an absurd attempt to 
"point a moral or adorn a tale." Yet this method had the 
approval of a professor of medicine in one of our largest 
Universities, and was adopted in the schools of one of our 



208 SHALL WE DRINK WINE ? 

wealthiest and most populous states through the influence 
of the superintendent of public instruction. 

The child who would carry home to a beer-drinking 
father the statement that "beer changes the inside coat of 
the stomach into leather" would be liable to have all the 
useful information he might acquire at school regarding 
the bad effects of alcohol neutralized by the superior wis- 
dom of the father. Indeed, I have before me now sev- 
eral letters written by irate fathers to teachers of public 
schools, in which these anti-alcohol teachings have been 
resented with much warmth, going so far even as personal 
abuse of the teacher. Let the truth be told about alcohol 
and alcoholic beverages to those children whom we would 
teach to avoid them, and no generous nature will, in ma- 
ture years, resent the teachings of his childhood and 
discard it all as false. 

But the education of the children alone is not sufficient. 
Some form of popular education should be inaugurated. 
In England scientific subjects were popularized and 
knowledge concerning them imparted by lecture. Work- 
ingmen's clubs listened With delight to popular lectures 
on scientific subjects given by Huxley, Tyndal, Darwin, 
Herbert Spencer, and others; and though there never 
can be another Huxley, Tyndal, nor Darwin, every com- 
munity of a few thousand inhabitants has one or more 
persons capable of treating the subject of alcohol from a 
scientific standpoint and at the same time making it in- 
teresting and easily understood. Let the subject be 
taught experimentally, as far as possible, demonstrating 
the falsity of the belief that alcohol gives strength or that 
beer is a valuable food, or that any of the alcoholic bev- 
erages have a tonic value. Surely the intelligent work- 
ingman who now spends from ten to twenty-five per cent 
of his daily wages for beer because he believes that beer 



BEST METHOD OF SUPPRESSING ALCOHOL. 209 

has a high food value would not spend the pittance which 
is so sorely needed by his family if he were convinced that 
in buying beer he is paying from ten to twenty times what 
he would have to pay for the same food in the form of 
bread. Nor would he end his substantial midday meal 
with a large glass of raw whiskey, as I have frequently 
seen him do, if he knew that he was thereby diminishing 
his strength and decreasing his digestive powers in a 
notable degree. Much of this kind of education should 
come from the medical profession. No thoughtful med- 
ical man will prescribe a drug so potent for evil as alcohol 
without being first assured that it meet the indications 
for which it is prescribed. He should not say to his 
patient "get a case of beer" or "get a case of wine" or 
spirits any more than he would say "get a pound of opium" 
or chloroform or chloral or any other dangerous narcotic. 
Let him know the truth about alcohol and prescribe it 
as he would any other narcotic of its class, warning his 
patient against its dangers and explaining to him the pop- 
ular errors regarding alcoholic beverages which have found 
credence and have passed uncontradicted from time 
immemorial. Let him tell the wealthy owner of a val- 
uable winecellar who is the victim of Bright's disease or 
the father of an imbecile child or inebriate son that his 
cherished winecellar is responsible for all his misfortune. 
It is nonsense to deny that thousands of useful, brilliant 
professional men and business men are yearly cut off in 
the very prime of their prosperity and usefulness by some 
disease engendered by a habit of daily alcohol imbibition, 
and who go to their graves not knowing the origin of 
their illness. The physician sees and knows (or should 
know), but he is silent. He may adopt the old English 
phrase and call it "high living"; but it is alcoholic degen- 
eration. 



210 SHALL WE DRINK WINE? 

Temperance advocates are wont to base their argu- 
ments on moral or moral-ethical grounds, neglecting the 
purely scientific side of the argument. The wisdom of 
this method is doubtful. Undoubtedly alcoholic excess 
is immoral and contravenes man's ethical relations to his 
fellows ; but it should be remembered that the social-ethical 
sense is first to be destroyed in alcoholic degeneration. 
To undertake to rouse the drunkard, therefore, by point- 
ing out the sufferings of others which his conduct entails 
is not so liable to succeed as would the conviction that his 
excesses must speedily end in death. 

While education of the people as to the exact nature 
and value of all alcoholic beverages may do much to bring 
about a total suppression of the liquor traffic, it alone 
will not be sufficient to do so. A multitude of people 
would drink and get drunk, even if they knew that alcohol 
possessed no value beyond its intoxicating effects and that 
the drinking thereof might be followed by dangerous or 
fatal disease. Great evils, too, are protected and propa- 
gated by the very inertia of custom and precedent. The 
evils of slavery were recognized at the time of the adoption 
of the constitution and measures taken to suppress the 
importation of slaves after 1808; but more than a half- 
century later a bloody and costly war was necessary to 
destroy that hideous institution. Traffic in alcoholic liquors 
will be tolerated for the same reason — the indisposition 
of the great mass of influential conservative citizens to 
interfere with established institutions — long after the 
people are educated to their worthlessness and dangers. 

The whole tide of public opinion must be changed. 
At the present time, in the average community, while there 
may be several shades of opinion as to the value of the 
different alcoholic liquors, nowhere is it considered posi- 
tively immoral nor even reprehensible to partake of any 



BEST METHOD OF SUPPRESSING ALCOHOL. 211 

form of alcohol drink "in moderation." The average 
public opinion looks upon it as a matter of course every- 
where excepting in comparatively unimportant localities, 
and these are treated by most people with a considerable 
measure of contempt. It is curious to note the different 
standards of morality which individuals make for them- 
selves in their different treatment of the alcohol question. 
There are certain men who have their liquors shipped to 
their residences who would feel degraded if seen drinking 
in a saloon. Others will drink a home-made wine contain- 
ing fifteen or twenty per cent of alcohol, who would look 
upon a bottle of five or six per cent wine from the wine 
merchant with abhorrence. A multitude of similar idio- 
syncrasies may be discovered with little trouble. There is, 
it is true, an undercurrent of feeling that the drinking of 
liquors, especially the stronger alcoholic liquors, is not 
entirely creditable. I have before me an advertisement 
for a whiskey, which I clipped, by the way, from a church 
paper, in which the would-be purchaser is assured that 
"we ship in plain packages — no marks to indicate contents 
(which will avoid possible comment)." The same desire 
not to be caught in the act of drinking accounts for the 
curtains always drawn and the screened bars of the saloon. 
But this tacit understanding that the drinking of alcoholic 
beverages is an evil has come to be regarded, like all the 
other evils of alcohol consumption, as a matter of course. It 
seems to have very little influence in the direction of cre- 
ating a public opinion sufficiently strong to inaugurate 
a movement for suppressing the evil. 

Our code of morals, however, will not permit us to 
regard the taking of opium with the same degree of 
equanimity. As has been elsewhere remarked, if anyone 
should enter into the business of dispensing pleasant tast- 
ing beverages having morphine, cocaine, hasheesh, or 



212 SHALL WE DRINK WINE? 

some other narcotic than alcohol, for their active princi- 
ple, how outraged the community would be, and if severe 
punishment were meted out to the originator of the enter- 
prise, it would be greeted with universal approval. The 
man, too, who habitually visits an "opium den" is shunned 
by his fellows and talked about with superstitious horror. 
This same man might go to an "alcohol den" a score of 
times every day without losing his reputation as a gentle- 
man, or the regard of his fellow men. This is simply 
because we are accustomed to seeing men indulge in 
alcoholic instead of other narcotic beverages. Let there 
be created a public opinion against the indulgence in all 
forms of narcotics, alcohol included, such as that which 
now exists against the indulgence in opium, and the liquor 
traffic will easily be abolished. 

Of greatest influence in perpetuating the custom of 
drinking alcoholic beverages is the important part which 
they play in the social intercourse of modern society, and 
especially in the everyday exchange of civilities between 
men of all kinds of business and all professions. To be 
invited to partake of some kind of alcoholic drink imme- 
diately opens the way to business negotiations, brushing 
away at once that reserve which makes the meeting of 
strangers more or less unpleasant, and opening up the 
way to a more intimate friendship. Moreover, custom 
has made the offering of a glass of wine one of the first 
duties of domestic hospitality with a vast majority of civ- 
ilized people. Indeed, this custom, through centuries of 
recognition by the world's most enlightened people, has 
become so essentially a part of our civilization that it will 
be the most difficult to abolish of all the causes which pro- 
mote alcohol drinking. It would seem that something of 
the kind is an absolute necessity. Yet what is there that 
can be made to take the place of alcoholic beverages which 



BEST METHOD FOR SUPPRESSING ALCOHOL. 213 

will be more acceptable? Undoubtedly coffee houses and 
other places where non-alcoholic drinks may be had, read- 
ing and lectures rooms and others in which games may be 
played are doing much to supply the medium of social 
intercourse, but a great deal of energy must be expended 
before they are made to totally supplant the saloon and 
winecellar. High license and all other restrictive legisla- 
tion which public opinion will allow to be adequately 
carried out should be earnestly supported until such time 
as alcohol for human consumption will be found only on 
the shelves of the apothecary and will be dispensed only 
upon the physician's prescription and only in such cases as 
call for sedative or narcotic treatment. 

As to the treatment of drunkenness, inebriety, and all 
pathological conditions arising from irritating effects of 
alcohol, each case is a separate problem and requires the 
intelligent handling of the skilled physician. Removal 
of patient from his surroundings, withdrawal of alcohol, 
support to the functions of nutrition, sedation for the nerv- 
ous system, until such time as the normal physiological 
processes are re-established, with proper protection against 
associations or nerve storms which would lead to renew- 
ing the habit, are the chief considerations. 



INDEX. 

A 

Page. 

Abstinence and Expectations in Life Insurance 192 

Adulterations of Alcoholic Beverages, Popular Belief in 169-171 

Adulterations of Wine 31 

Adulterations of Beer 33-34 

Adulterations of Spirits 34-36 

Aggressiveness of Liquor Traffic 205 

Alcoholic Excess Among Ancient Germans 17-20 

Alcoholic Excess Among Germans in Middle Ages 20-25 

Alcoholic Excess In England 24-25 

Alcoholic Excess Present Day 25 

Alcohol, Oxidation in the Body 31 et seq. 

Alcohol, Elimination of 41 

Alcohol, Affinity for Oxygen 42 

Alcohol Not a Carbohydrate Food 43-44 

Alcohol in U. S. Army 56 

Alcohol in Morbidity and Mortality in Switzerland 191 

Ancient History of Wine Making 9 

Ancient History of Beer Making 10-11 

Assimilation, Effects of Alcohol upon 70 

Austria, Alcoholic Insanity in 123-124 

B 

Beer, Adulterations of 34-36 

Beer, Amount of Alcohol in 34 

Beer, Constituents of 34 

Beer, Contains no Diastase 164 

Beer Drinking and Inebriety 184 

Beer Drunkard, Appearance of 164 

Beer, Evils of Drinking 183 

Beer Compared with Bread, Food Value of 46-47 

Beer, German contains more Sugar than American 164 

Beer, Material used for Coloring 36 

Beer Making Among Germans, Growth of 19 

215 



216 INDEX— CONTINUED. 

Page. 

Beer, Popular Estimation of 163 

Beer Produces Unlimited Drunkenness 163 

Beer, Stomach Troubles Produced by 166 

Beer, Why It increases Bodily Weight 163-164 

Belief That Alcohol is a Natural Stimulant 172 

Boquet of Wine, What ? 168 

Brewing Among Ancient Central Americans 14-15 

Brewing Among Ancient Egyptians 10 

Brewing Among Ancient Greeks 11 

Brewing Among Ancient Mexicans 12 

Brewing Among Polynesians 17 

Brewing Among Romans 12 

Brewing Among South Americans 15-16 

c 

Careless Prescribing of Alcohol 175 

Character, Effects of Alcohol Upon 95 et seq. 

Children, Effects of Alcohol Upon 101-102 

Chemical Effects of Alcohol on Digestion 67 

Cholera, Susceptibility Increased by Alcohol 67-72 

Commercial Inebriate Cures 157-158 

Consumption of Alcohol in Europe 189 

Corruption of Municipal Affairs by Alcohol 200-201 

Crime, Relation to Alcoholism 193 et seq. 

Crime, Committed by ''Occasional Drunkards" 195 

Crime, Committed by "Constant Drunkards" 195-197 

Crime, Amount for which Alcohol is Responsible 197-198 

Crime, Days of Week upon which Committed 197 

D 

Degeneration of Nerve Cells, Alcoholic 93-94 

Digestion, Effects of Alcohol upon 66 et seq. 

Diseases, Alcohol in Treatment of 129 

Dispensaries, Government 202 

Drunkards, Reasons for More Males 140 

Drunkards, Social Influences in Making 139 

Drunkards, Who Become 139-140 

Drunkenness Among Germans in the XVI Century 20-25 

Drunkenness in England in XVIII Century 23-24 

Drunkenness, A Bar to Progress 198 

Drunkenness, A Cause of Human Misery 198 



INDEX— CONTINUED. 217 

E 

Page. 

Education Concerning Alcohol, Popular 208 

Elimination of Alcohol 41 

Embryo, Effects of Alcohol Upon 104-108 

Excretion of Oxidized Products of Alcohol 43 

Exhaustion, Heart, In Alcoholism 83-86 

Ethics of Opium and Alcohol Indulgence 213 

F 

Families, Alcoholic, Soon Run Out 115 

Fatigue, Effects of Alcohol Upon 160 

Fermentation, By-Products of 171 

Food Value of Beer vs. Bread 46-47 

France, Alcoholic Insanity in 111-112 

France, Increase of Alcoholic Consumption in 123 

G 

Gambrinus, Origin of 26 

Gas, Exchange Affected by Alcohol 74 

Germany, Alcoholic Insanity in 122-123 

Germany, Prevalence of Alcoholic Poisoning in 124 

Glycogenic Functions Affected by Alcohol 72 

Gothenburg System 204-205 

H 

Habitual Drinkers and Total Abstainers, Different Effects of 

Alcohol upon 72-73 

Heart Diseases of Alcoholism 83 et seq. 

Heart Exhaustion of Alcoholism 83-86 

Heart in Alcoholism, Chronic Diseases of 86 

Heart Dilatation 87-88 

Heredity, Influence of Alcohol upon 103-116 

Home Drinking, Ethics of 211 

Hops, Substitutes For 35 

I 

Illness Due to Alcohol, Amount of 189-190 

Inebriety, What ? 141 

Inebriety, Constant 152 

Inebriety, Constant, Causes of 152 

Inebriety, Former Punishment For 142 



218 INDEX— CONTINUED. 

Page. 

Inebriety, Periodic 145-151 

Inebriety, Popular Interpretation of 142 

Inebriety, Real and Pseudo 143-144 

Inebriate, Constant Not Always a Degenerate 154 

Inebriates, Alcoholic Degeneracy of 108-111 

Inebriates, Criminal Tendencies of 113 

Immunity Against Alcoholic Poisoning 114 

Insanity, Alcoholic 117-127 

Insanity, Alcoholic, Statistics of 117-122 

Insanity, Alcoholic, in Massachusetts 119-121 

Insanity, Alcoholic, in Germany 122-123 

Insanity, Alcoholic, in France 123 

Insanity, Alcoholic, in Austria 123-124 

Insanity, Alcoholic, Among German Children 125-126 

K 

Kidney, Alcoholic Diseases of 89 

L 

Liquor Traffic, Aggressiveness of 205 

Liquor Traffic, Suppression of 202 

Liquor Traffic, Loss Entailed by 187-188 

Liquor Traffic, Power of 205-206 

Liver, Alcoholic Diseases of 90 

Loss to State Through Drunkenness 200 

M 

Malt in Beer, Substitutes For 34-35 

Malt Liquors and Wine, Comparative Effects of 168 

Malt Liquors, Increase in Consumption of 182 

Medicine, Alcohol as a 174 

Mental Processes, Effects of Alcohol Upon 57 et seq. 

Metabolism, Effects of Alcohol Upon 71 

Moderate Drinking, Bar to Highest Happiness 198 

Money Spent for Alcoholic Drinks 184-186 

Morel's Table of Alcoholic Degeneration 113 

Motor Disturbances of Alcoholism 98-99 

Mortality, Alcoholic, in Switzerland 191-192 

Morbidity, Alcoholic, in English Army 192 

Municipal Affairs and Alcohol 200-201 

Muscular Contractions Affected by Alcohol..... 49 et seq. 



INDEX— CONTINUED. 219 

Paere. 

Muscular Movements of Stomach Affected by Alcohol 69 

N 

Narcotic, Alcohol an Inferior 175-176 

Nerve Cells in Alcoholism, Degeneration of 93-94 

Nerve Tissue, Effects of Alcohol upon 91-94 

o 

Opium and Alcoholic Indulgence, Ethics of 212 

Oxygen, Affinity of Alcohol for 42 

P 

Paralysis in Alcoholism 99-100 

Periodic Drunkards 145-151 

Peripheral Nerves in Alcoholism, Degeneration of 100 

Peripheral Nerves of Stomach, Effects of Alcohol upon 69 

Physicians Duty to Public in the Use of Alcohol 209 

Per Capita Consumption of Alcohol 178, 189 

Popular Errors about Alcoholic Beverages 159 at seq. 

Popular Estimate of Wine 166 

Popular Belief in Adulterations 169-171 

Popular Education about Alcohol 211-212 

Physicians and The Value of Alcohol 128-138 

Physicians and The Use of Alcohol 50 years Ago 129 

Physicians, Recent Opinions Favorable to Alcohol 131-136 

Proteid Metabolism, Affected by Alcohol 71 

Ptyalin, Effects of Alcohol Upon 71 

Prohibition, Difficulty of Obtaining 203 

R 

Reformation of Drunkards, Accidental 155-156 

Resistance, Tissue, Decreased by Alcohol 75 

Russia, Drunkenness Among Children of 126 

s 

Saloon, Evil Influences of 201 

Saloon, Substitutes for 213 

Schools, Temperance Taught in 207 

Social Drinking in Producing Inebriety, Effects of 145-146 

Special Senses in Alcohol, Disturbances of 98 

Spirits, Adulterations of 33-34 

Spirits, Constituents of 31-33 



220 INDEX— CONTINUED. 

Page. 

Spirits, Materials to Color 33 

Stimulant, What it is 48 

Stimulant, Alcohol not, in Chloroform Narcosis 54 

Stimulates, How Alcohol 55 et seq. 

State by Drunkenness, Loss to 200 

Stomach, Effects of Alcohol Upon 66-69 

Stomach Troubles Produced by Beer 166 

Sugar Compared with Alcohol, Food Value of 46 

Suppression of Liquor Traffic 202 

Switzerland, Mortality Statistics of 191 

T 

Temperance Taught in Schools 207 

Temperature, Effects of Alcohol upon 161 

Temperance Hospital, London 174 

Tissue Resistance Decreased by Alcohol 75 et seq. 

Tissue, How Broken Down by Alcohol 103 

Toxicity of Alcohol 177 

Tuberculosis and Alcoholism 78 et seq. 

w 

Wine Drinking Among Early Germans 17 

Wine Making, Origin of 10 

Wine, Constituents of 29-31 

Wine, Adulterations of 31 

Wine, Materials Used in Coloring 31 

Wine, Old, Popular Estimation of 166 



UN 5 1899 



